Mindful Balance Psychological Wellness LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MINDFUL BALANCE PSYCHOLOGICAL WELLNESS LLC

Practice address

130 E Liberty St
Plymouth, MI 48170-1413

Phone

(734) 656-8611

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Ryan Bidan

Title

Owner

Phone

(214) 535-9418

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499904000000",
    "number": "1316469174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HIGH CANYON CT",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802670",
            "telephone_number": "214-535-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E LIBERTY ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701413",
            "telephone_number": "734-656-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL BALANCE PSYCHOLOGICAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A",
        "authorized_official_last_name": "BIDAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-535-9418"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Miller
• Torrie-Jo L Miller
• Benjamin C Mills, CCP
• Jenna Elaine Millstead, MD
• Michelle Milzow
• Mindful Wellness Counseling, LLC
• Melissa Minhinnick
• Kathryn Grace Minier
• George Bruce Minor
• David Minsky

• Clinic/Center in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.