NPIMap

Organization Active NPI

Mind Body and Spirit Counseling Services, LLC

  • Professional Counselor
  • Palmdale, CA
National Provider Identifier
1194159004
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MIND BODY AND SPIRIT COUNSELING SERVICES, LLC
Practice address
241 W Quail Dr
Palmdale, CA 93551-2943
Phone
(714) 803-0268
NPI assigned
Aug 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Authorized official

Name
Dr. Woodrow Anthony Roeback III, PHD, LPCC, CPCNPI 1356681241
Title
Owner
Phone
(702) 917-9309

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X CI0077 NV
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

241 W Quail Dr
Palmdale, CA 93551-2943

Mailing address

241 W Quail Dr
Palmdale, CA 93551-2943
Phone (714) 803-0268

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://provider.kareo.com/dr-woodrow-roeback-2 Direct

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": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1194159004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 W QUAIL DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935512943",
            "telephone_number": "714-803-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W QUAIL DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935512943",
            "telephone_number": "714-803-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY AND SPIRIT COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "ROEBACK",
        "authorized_official_first_name": "WOODROW",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-917-9309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHD, LPCC, CPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI0077",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://provider.kareo.com/dr-woodrow-roeback-2",
            "affiliation": "N",
            "endpointDescription": "Mind Body and Spirit Counseling Services webpage",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "241 W Quail Dr",
            "city": "Palmdale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935512943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.