Mind & Body Psychotherapy Inc

Primary specialty

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

Legal business name

MIND & BODY PSYCHOTHERAPY INC

Practice address

201 E Grand Ave Ste 2a
Escondido, CA 92025-2818

Phone

(619) 395-2885

NPI assigned

Apr 4, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Leanne Self, PSY.D.NPI 1669741815

Title

Owner/Psychologist

Phone

(619) 395-2885

Specialties & licenses 1

Addresses

Other names 1

• The Clinical Office of Dr. Leanne Self, APPC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Leanne Self, PSY.D.

  • Clinical Psychologist
  • Escondido, CA
  • NPI 1669741815
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1215632476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 W EL NORTE PKWY # 48",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920263341",
            "telephone_number": "619-395-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E GRAND AVE STE 2A",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920252818",
            "telephone_number": "619-395-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & BODY PSYCHOTHERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "619-395-2885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "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": [
        {
            "organization_name": "The Clinical Office of Dr. Leanne Self, APPC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nicole Miller
• Samantha Miller
• Barbara Alice Milligan
• Razel Bacuetes Milo, PHD, DNP, FNP-C
• Amanda Mims
• Jennifer Marie Minisci
• Peter Minkoff, M.D.
• Mona Shah Minton, IMF
• Miracle Ear
• Miracle Ear

• Mental Health Clinic/Center (Including Community Mental Health Center) in Escondido, CA
• Providers in Escondido, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.