NPIMap

Organization Active NPI

Mindful Healing Therapy and Wellness, LLC

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1366968554
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW14306 Issued in FL
Legal business name
MINDFUL HEALING THERAPY AND WELLNESS, LLC
Practice address
400 E Dr Martin Luther King Jr Blvd Ste 101
Tampa, FL 33603-3866
Phone
(813) 236-4673
Fax
(813) 236-4689
NPI assigned
Aug 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Jessica R Greaves, MSW, LCSW
Title
Owner, Psychotherapist
Phone
(813) 505-6867

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X SW14306 FL Primary
Developmental Disabilities Clinic/Center 261QD1600X SW14306 FL
Adult Mental Health Clinic/Center 261QM0850X SW14306 FL
Adolescent and Children Mental Health Clinic/Center 261QM0855X SW14306 FL

Addresses

Primary practice location

400 E Dr Martin Luther King Jr Blvd Ste 101
Tampa, FL 33603-3866

Mailing address

400 E Dr Martin Luther King Jr Blvd Ste 101
Tampa, FL 33603-3866
Phone (813) 236-4673

National Provider Directory

National Provider Directory

Locations

400 E Dr Martin Luther King Jr Blvd
Ste 101
Tampa, FL 33603
Phone (813) 236-4673

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1366968554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E DR MARTIN LUTHER KING JR BLVD STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033866",
            "telephone_number": "813-236-4673",
            "fax_number": "813-236-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E DR MARTIN LUTHER KING JR BLVD STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033866",
            "telephone_number": "813-236-4673",
            "fax_number": "813-236-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL HEALING THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GREAVES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER, PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "813-505-6867",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW14306",
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "SW14306",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "SW14306",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "FL",
            "license": "SW14306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.