Organization Active NPI

Mindful Living Therapy, a Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1336960616
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL LIVING THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Practice address
3400 Cottage Way
Suite G2 #26201
Sacramento, CA 95825
Phone
(323) 918-7868
NPI assigned
Oct 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Kristin Ortiz, LCSWNPI 1851965974
Title
President
Phone
(323) 918-7868

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

3400 Cottage Way
Suite G2 #26201
Sacramento, CA 95825

Mailing address

3400 Cottage Way
Suite G2 #26201
Sacramento, CA 95825
Phone (323) 918-7868

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1336960616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 COTTAGE WAY",
            "address_2": "SUITE G2 #26201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "323-918-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 COTTAGE WAY",
            "address_2": "SUITE G2 #26201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "323-918-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LIVING THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-918-7868",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.