NPIMap

Organization Active NPI

Mindful Way Therapy LLC

  • Clinical Social Worker
  • Farmington Hills, MI
National Provider Identifier
1285296616
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL WAY THERAPY LLC
Practice address
37875 W 12 Mile Rd Ste 201
Farmington Hills, MI 48331-3037
Phone
(248) 881-3457
NPI assigned
Jul 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Ms. Rebecca A Congdon, LMSWNPI 1063664118
Title
Licensed Social Worker
Phone
(248) 881-3457

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

37875 W 12 Mile Rd Ste 201
Farmington Hills, MI 48331-3037

Mailing address

37875 W 12 Mile Rd Ste 201
Farmington Hills, MI 48331-3037
Phone (248) 881-3457

Other names 1

  • REBECCA CONGDON SOLE MBR Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL TherapyNotes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190913001523 MI Part B Supplier - Clinic/Group Practice 6204165418 Receives reassigned benefits from 4 practitioners
Practice locations: Farmington Hills, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1562371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1285296616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37875 W 12 MILE RD STE 201",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313037",
            "telephone_number": "248-881-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37875 W 12 MILE RD STE 201",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313037",
            "telephone_number": "248-881-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL WAY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-06",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "CONGDON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSED SOCIAL WORKER",
        "authorized_official_telephone_number": "248-881-3457",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TherapyNotes",
            "affiliation": "N",
            "address_1": "37875 W 12 Mile Rd Ste 201",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483313037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "REBECCA CONGDON SOLE MBR",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "REBECCA CONGDON SOLE MBR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.