NPIMap

Organization Active NPI

Mindful Wellness of Arizona PLLC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1376041418
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MINDFUL WELLNESS OF ARIZONA PLLC
Practice address
4111 E Valley Auto Dr Ste 209
Mesa, AZ 85206-4609
Phone
(480) 666-5502
NPI assigned
Jan 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Jessica SissonNPI 1679090369
Title
Owner
Phone
(480) 666-5502

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4111 E Valley Auto Dr Ste 209
Mesa, AZ 85206-4609

Mailing address

4111 E Valley Auto Dr Ste 209
Mesa, AZ 85206-4609

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1376041418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064609",
            "telephone_number": "480-666-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL WELLNESS OF ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "SISSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-666-5502"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.