Mindful Health Tbi Center Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MINDFUL HEALTH TBI CENTER INC

Practice address

37 Hanover Rd
Marlton, NJ 08053-1905

Phone

(609) 784-3576

NPI assigned

Oct 12, 2020

Last updated

Oct 12, 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

Amy M Coleman, LPC

Title

Ceo

Phone

(609) 784-3576

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1306444518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 HANOVER RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531905",
            "telephone_number": "609-784-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 HANOVER RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531905",
            "telephone_number": "609-784-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL HEALTH TBI CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-784-3576",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisa B Miller, LCSW
• Bruce L Miller
• Matthew Miller, PSY.D.
• Scott L Miller, M.D.
• Mind Your Mental Health Services LLC
• Mindful Living Counseling and Consulting
• Mindful Therapy Center, LLC (Mindful Therapy)
• Mindwave Diagnostics
• Raema Mir, M.D.
• John C. Mirmanesh, M.D.

• Mental Health Counselor in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.