Organization Active NPI

Mind Body Soul and Spirit MBSS

  • Psychiatric/Mental Health Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1184438350
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MIND BODY SOUL AND SPIRIT MBSS
Practice address
2269 Hialeah St NE
Palm Bay, FL 32907-2650
Phone
(321) 244-7067
NPI assigned
Feb 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Verona Estella Haughton, NPNPI 1295579589
Title
Owner
Phone
(321) 244-7067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2269 Hialeah St NE
Palm Bay, FL 32907-2650

Mailing address

2269 Hialeah St NE
Palm Bay, FL 32907-2650
Phone (321) 244-7067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250606003547 FL Part B Supplier - Clinic/Group Practice 0749790996 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Bay, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1184438350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2269 HIALEAH ST NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072650",
            "telephone_number": "321-244-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 HIALEAH ST NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072650",
            "telephone_number": "321-244-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SOUL AND SPIRIT MBSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "HAUGHTON",
        "authorized_official_first_name": "VERONA",
        "authorized_official_middle_name": "ESTELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-244-7067",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.