Mind-Body Management, LTD.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PC004790 Issued in PA

Legal business name

MIND-BODY MANAGEMENT, LTD.

Practice address

108 S Church St
Macungie, PA 18062-1038

Phone

(610) 462-5585

Fax

(610) 966-5616

NPI assigned

Mar 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kelli J Deiaco, PHDNPI 1699945766

Title

President

Phone

(610) 462-5585

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.

• Kelli J Deiaco, PH.D.

  • Clinical Psychologist
  • Lewes, DE
  • NPI 1699945766
  NPD (past) Authorized official

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1396987046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S CHURCH ST",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180621038",
            "telephone_number": "610-462-5585",
            "fax_number": "610-966-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S CHURCH ST",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180621038",
            "telephone_number": "610-462-5585",
            "fax_number": "610-966-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND-BODY MANAGEMENT, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "DEIACO",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-462-5585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "PC004790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Associates of the Lehigh Valley PC
• Medline Direct LLC
• Karen Melici, MSW, LCSW
• Susan Moon Meyer, PH.D.
• Phallentz Michel, LPN
• Faith Montgomery
• Bethany Moyer
• Debra Ann Moyer, C.O.T.A.L
• Andrew William Mulvey, M.D.
• Reshma R Nair, MD

• Adult Mental Health Clinic/Center in Macungie, PA
• Providers in Macungie, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.