NPIMap

Organization Active NPI

Mind Body Center

  • Adult Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1346877412
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MIND BODY CENTER
Practice address
2551 N Clark St Ste 301
Chicago, IL 60614-7732
Phone
(978) 697-5301
NPI assigned
Mar 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Authorized official

Name
Mrs. Melissa Ann St Jean, LCPCNPI 1821506098
Title
Owner
Phone
(978) 697-5301

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2551 N Clark St Ste 301
Chicago, IL 60614-7732

Mailing address

2551 N Clark St Ste 301
Chicago, IL 60614-7732
Phone (978) 697-5301

National Provider Directory

National Provider Directory

Locations

2551 N Clark St
Ste 301
Chicago, IL 60614
Phone (978) 697-5301

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": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1346877412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 N CLARK ST STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147732",
            "telephone_number": "978-697-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 N CLARK ST STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147732",
            "telephone_number": "978-697-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "ST JEAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-697-5301",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.