Mindful Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL WELLNESS LLC

Practice address

13797 E Evans Creek Rd
Rogue River, OR 97537-9778

Phone

(541) 973-1361

NPI assigned

Mar 6, 2024

Last updated

Mar 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Shamblin, LCSWNPI 1023457504

Title

Licensed Clinical Social Worker

Phone

(541) 973-1361

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Shamblin, LCSW

  • Clinical Social Worker
  • Rogue River, OR
  • NPI 1023457504
  Authorized official Same address or phone

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1356108286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1504",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975371504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13797 E EVANS CREEK RD",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975379778",
            "telephone_number": "541-973-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "SHAMBLIN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "541-973-1361",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian John Mateja, D.O.
• Teresa Marie McConnell, L.M.T
• Martin Dale McIntosh, D.C.
• Susan L McKewen, PT
• Heather Calleen Merlo-Grifantini, MD
• Jeri Lynn Mize, LMT
• Morrow Alf, LLC (Morrow Heights Assisted Living)
• Morrow Heights
• Sheri L. Nelsen, L.M.T.
• Warren R Norberg, P.T.

• Clinical Social Worker in Rogue River, OR
• Providers in Rogue River, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.