Mind & Body Balance, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149010662 Issued in IL

Legal business name

MIND & BODY BALANCE, LLC

Practice address

1300 W Belmont Ave Ste 407
Chicago, IL 60657-3242

Phone

(773) 403-5149

NPI assigned

Jun 17, 2010

Last updated

Nov 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joanne FlomNPI 1962609255

Title

Social Worker

Phone

(773) 403-5149

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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.

• Joanne Flom, L.C.S.W.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1962609255
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1215258991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4443 N RICHMOND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253823",
            "telephone_number": "773-403-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE STE 407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573242",
            "telephone_number": "773-403-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & BODY BALANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "FLOM",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "773-403-5149"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Minami, M.D.
• Kanokporn Minanond
• Frank Minardi, D.O.
• Madeline Minaudo
• Ismely Fiorella Minaya, M.D.
• Mind 2 Heart LLC
• Mind Altering Therapy & Consulting Services LLC
• Mind and Movement Therapy PLLC
• Mind at Ease LLC
• Mind Balance Psychotherapy PLLC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.