Brain Body Soul Therapy and Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BRAIN BODY SOUL THERAPY AND WELLNESS LLC

Doing business as

Brain body soul therapy and wellness llc

Practice address

2488 E 81St St Ste 4821
Tulsa, OK 74137-4290

Phone

(918) 236-0833

NPI assigned

Jul 27, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Robert Carson Raymond, LPCNPI 1437758257

Title

President

Phone

(918) 236-0833

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brain body soul therapy and wellness llc Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Carson Raymond

  • Mental Health Counselor
  • Tulsa, OK
  • NPI 1437758257
  NPD Authorized official

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

{
    "created_epoch": "1722038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1366271512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 E 90TH ST UNIT 1806",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373377",
            "telephone_number": "734-646-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 4821",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374290",
            "telephone_number": "918-236-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN BODY SOUL THERAPY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-27",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CARSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-236-0833",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200946240B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brain body soul therapy and wellness llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Mental Health Counselor in Oklahoma

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