NPIMap

Organization Active NPI

Mind Matters Therapy, LLC

  • Clinical Social Worker
  • West Boylston, MA
National Provider Identifier
1407110067
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113193 Issued in MA
Legal business name
MIND MATTERS THERAPY, LLC
Practice address
354 W Boylston St
Suite 225
West Boylston, MA 01583-2373
Phone
(508) 852-4800
NPI assigned
Jun 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Michelle L Chunis, LICSW
Title
Owner
Phone
(508) 852-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 113193 MA Primary

Addresses

Primary practice location

354 W Boylston St
Suite 225
West Boylston, MA 01583-2373

Mailing address

354 W Boylston St
Suite 225
West Boylston, MA 01583-2373
Phone (508) 852-4800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1407110067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 W BOYLSTON ST",
            "address_2": "SUITE 225",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832373",
            "telephone_number": "508-852-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 W BOYLSTON ST",
            "address_2": "SUITE 225",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832373",
            "telephone_number": "508-852-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND MATTERS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "CHUNIS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-852-4800",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.