NPIMap

Organization Active NPI

Mindful Balance Mental Health & Wellness, LLC

  • Mental Health Counselor
  • Marysville, MI
National Provider Identifier
1316646953
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDFUL BALANCE MENTAL HEALTH & WELLNESS, LLC
Practice address
1124 Gratiot Blvd
Marysville, MI 48040-1133
Phone
(810) 434-0462
NPI assigned
Mar 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Robert Damien Perrin, LMSWNPI 1548221500
Title
Owner
Phone
(810) 434-0462

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1124 Gratiot Blvd
Marysville, MI 48040-1133

Mailing address

5325 Lockwood Dr
Washington, MI 48094-2632
Phone (586) 214-2218

National Provider Directory

National Provider Directory

Locations

1124 Gratiot Blvd
Marysville, MI 48040
Phone (586) 214-2218

Practitioners & affiliated clinicians

Practitioners 7

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": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1316646953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 LOCKWOOD DR",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480942632",
            "telephone_number": "586-214-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401133",
            "telephone_number": "810-434-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL BALANCE MENTAL HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "PERRIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DAMIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-434-0462",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.