Active NPI
Mindshift Center, LLC
- Professional Counselor
- Quincy, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- MINDSHIFT CENTER, LLC
- Practice address
- 120 S 10TH St
Quincy, IL 62301-4008 - Phone
- (217) 440-6247
- NPI assigned
- Sep 22, 2020
- Last updated
- Sep 25, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Angel Knoverek, PHD
- Title
- Owner
- Phone
- (217) 440-6247
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
120 S 10TH St
Quincy, IL 62301-4008
Mailing address
120 S 10TH St
Quincy, IL 62301-4008
Phone (217) 440-6247
National Provider Directory
National Provider DirectoryLocations
120 S 10th St
Quincy, IL 62301
Phone (217) 440-0444
822 State St
Ste 10
Quincy, IL 62301
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Professional Counselor
- Quincy, IL
- NPI 1417242157
-
- Mental Health Counselor
- Quincy, IL
- NPI 1699646935
-
- Professional Counselor
- Glennallen, AK
- NPI 1568965408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600732800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695600000000",
"number": "1194331447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 S 10TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014008",
"telephone_number": "217-440-6247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S 10TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014008",
"telephone_number": "217-440-6247"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDSHIFT CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-22",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A",
"authorized_official_last_name": "KNOVEREK",
"authorized_official_first_name": "ANGEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "217-440-6247",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.