Mindbodysoulworks, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MINDBODYSOULWORKS, LLC

Practice address

4190 E Lake Rd
Erie, PA 16511-1355

Phone

(814) 616-2858

Fax

(814) 616-2860

NPI assigned

Jan 9, 2019

Organization subpart

No

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

Authorized official

Name

Mary Rudolph, BSN, RN, LCSW

Title

Therapist/Owner

Phone

(814) 616-2858

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Steven Daniel Krauza, D.C.

  • Chiropractor
  • Erie, PA
  • NPI 1770546376
  NPD (past)

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1205309531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 E LAKE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165111355",
            "telephone_number": "814-616-2858",
            "fax_number": "814-616-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 E LAKE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165111355",
            "telephone_number": "814-616-2858",
            "fax_number": "814-616-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDBODYSOULWORKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "814-616-2858",
        "authorized_official_credential": "BSN, RN, LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody L Milliron, DO
• Joseph Millward, RPH.
• Staci Lyn Millward, RPH
• Darlene M. Miltenburg, M.D.
• Darlista Mims, LPN
• Mindset Over Matter LLC
• Cathleen Anna Miner, PH.D.
• Deborah L. Mingey, M.D.
• John Richard Mingey, MD
• Minichelli Dentistry, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Erie, PA
• Providers in Erie, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.