Mind Evolution

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIND EVOLUTION

Practice address

401 Wisconsin Ave
Madison, WI 53703-1487

Phone

(608) 256-5115

NPI assigned

May 9, 2019

Organization subpart

No

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

Authorized official

Name

Rachele Klassy, LCSW

Title

Owner

Phone

(608) 206-3767

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1245895754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 HWY 69",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "53508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WISCONSIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031487",
            "telephone_number": "608-256-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND EVOLUTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "KLASSY",
        "authorized_official_first_name": "RACHELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-206-3767",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milwaukee Health Services System, LLC
• Milwaukee Health Services System, LLC
• Sandra M Milz, APNP
• Andra Ioana Mina, NP
• Mind and Match Wisconsin, S.C.
• Mind Over Matter
• Dave Minden, PH.D.
• Mindful Growth Psychotherapy, LLC
• Mindful Healing Counseling LLC
• Mindful Motion Physical Therapy, LLC

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.