NPIMap

Organization Active NPI

Mindful Matters LLC

  • Community/Behavioral Health Agency
  • Kaukauna, WI
National Provider Identifier
1407249303
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
4647-125 Issued in WI
Legal business name
MINDFUL MATTERS LLC
Practice address
W2274 Out of Town LN
Kaukauna, WI 54130-9474
Phone
(920) 209-0604
NPI assigned
Mar 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Mrs. Amy Lynn Vanden Heuvel, LCPNPI 1174831473
Title
Licensed Professional Counselor
Phone
(920) 209-0604

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
Community/Behavioral Health Agency 251S00000X 4647-125 WI Primary

Addresses

Primary practice location

W2274 Out of Town LN
Kaukauna, WI 54130-9474

Mailing address

W2274 Out of Town LN
Kaukauna, WI 54130-9474
Phone (920) 209-0604

Other identifiers 1

IdentifierTypeStateIssuer
1174831473MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Mindful Matters2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1407249303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2274 OUT OF TOWN LN",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541309474",
            "telephone_number": "920-209-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W2274 OUT OF TOWN LN",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541309474",
            "telephone_number": "920-209-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MATTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "VANDEN HEUVEL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "920-209-0604",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "4647-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174831473",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.