NPIMap

Organization Active NPI

Mind and Body Behavioral Health Center

  • Preferred Provider Organization
  • Canton, MA
National Provider Identifier
1245691203
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
7326 Issued in MA
Legal business name
MIND AND BODY BEHAVIORAL HEALTH CENTER
Practice address
575 Washington St
Unit 2D
Canton, MA 02021-3011
Phone
(508) 468-7218
NPI assigned
Mar 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Jenny T Ventura, LMHCNPI 1871765214
Title
Owner
Phone
(508) 243-9331

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
Preferred Provider Organization 305R00000X 7326 MA Primary

Addresses

Primary practice location

575 Washington St
Unit 2D
Canton, MA 02021-3011

Mailing address

575 Washington St
Unit 2D
Canton, MA 02021-3011
Phone (508) 468-7218

National Provider Directory

National Provider Directory

Locations

575 Washington St
Ste 2D
Canton, MA 02021
Phone (508) 468-7218

Practitioners & affiliated clinicians

Practitioners 2

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": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1245691203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 WASHINGTON ST",
            "address_2": "UNIT 2D",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020213011",
            "telephone_number": "508-468-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 WASHINGTON ST",
            "address_2": "UNIT 2D",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020213011",
            "telephone_number": "508-468-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "VENTURA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-243-9331",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MA",
            "license": "7326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.