Mindful Life Full LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL LIFE FULL LLC

Practice address

3063 Bay St
Gulf Breeze, FL 32563-3105

Phone

(773) 368-9619

NPI assigned

Nov 13, 2020

Last updated

Nov 13, 2020By 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

Georgia Jones, LCSWNPI 1356365209

Title

Owner

Phone

(773) 368-9619

Specialties & licenses 1

Addresses

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.

• Georgia Lorraine Jones

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1356365209
  NPD Authorized official

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1255933214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3063 BAY ST",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633105",
            "telephone_number": "773-368-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3063 BAY ST",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633105",
            "telephone_number": "773-368-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LIFE FULL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-368-9619",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lester Meyers, PSY.D.
• Judith Eileen Meyers, PSYD
• Midway Fire District
• Sophie Miller
• Michael Darrell Milligan, MD
• Sophie Mislevy
• Tammy Mitchell, PA-C
• Samantha Monroe
• Hannah Moody
• Abigail Elizabeth Morgan, DPT

• Clinical Social Worker in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.