NPIMap

Organization Active NPI

Mind Body and Spirit Therapy LLC

  • Professional Counselor
  • Tulsa, OK
National Provider Identifier
1205598877
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MIND BODY AND SPIRIT THERAPY LLC
Practice address
4444 E 31St St
Tulsa, OK 74135-2131
Phone
(191) 874-9199
NPI assigned
Oct 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Jacqueline BontragerNPI 1245655448
Title
Owner
Phone
(918) 340-0267

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4444 E 31St St
Tulsa, OK 74135-2131

Mailing address

4444 E 31St St
Tulsa, OK 74135-2131
Phone (918) 340-0267

Other names 1

  • Jacqueline Bontrager Other name

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": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1205598877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352131",
            "telephone_number": "918-340-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352131",
            "telephone_number": "191-874-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY AND SPIRIT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "BONTRAGER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-340-0267"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacqueline Bontrager",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.