Mindfullyme Mental Health PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MINDFULLYME MENTAL HEALTH PLLC

Practice address

2505 Main St Ste 208
Stratford, CT 06615-5813

Phone

(203) 682-5278

NPI assigned

Dec 1, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline Ivana StevensNPI 1033972500

Title

Owner

Phone

(203) 682-5278

Specialties & licenses 3

Addresses

Other names 1

• MindFullyMe Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Ivana Stevens, LMSW

  • Social Worker
  • Bridgeport, CT
  • NPI 1033972500
  Medicare reassignment NPD Authorized official
• George J Costanzo, D.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Southington, CT
  • NPI 1467401802
  NPD (past)
• Robert Joseph Hurley, LCSW

  • Clinical Social Worker
  • Stratford, CT
  • NPI 1366414237
  NPD (past)

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1306708235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 POST RD STE 200",
            "address_2": "#164711",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MAIN ST STE 208",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155813",
            "telephone_number": "203-682-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULLYME MENTAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-11-30",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "IVANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-682-5278",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MindFullyMe Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vincent N Miles, M.D.
• Goran Miljkovic, M.D.
• Peter Milner
• Robert M. Milstein, M.D.
• Mind After Mind Inc
• Suha H Mishalani, M.D.
• Aleksandra Misiewicz
• Cristal Mitchell
• John P. Mitchell, RPH
• Navnit S. Mitter, MSC, MS, PHD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Stratford, CT
• Providers in Stratford, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.