Mindful Marriage and Family Therapy, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LCM570 Issued in MD

Legal business name

MINDFUL MARRIAGE AND FAMILY THERAPY, LLC

Practice address

2502 Urbana Pike
Ijamsville, MD 21754-8602

Phone

(301) 281-4963

NPI assigned

Mar 16, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Leslee Sophia Bry, LCMFTNPI 1144694969

Title

Owner

Phone

(301) 514-8120

Specialties & licenses 1

Addresses

Tax ID family

Mindful Marriage and Family Therapy LLC2 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.

• Mindful Marriage and Family Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1427548569
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslee Bry, LCMFT

  • Marriage & Family Therapist
  • Frederick, MD
  • NPI 1144694969
  NPD Authorized official

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1407359268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 BUCKEYSTOWN PIKE # 123",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047535",
            "telephone_number": "301-514-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 URBANA PIKE",
            "city": "IJAMSVILLE",
            "state": "MD",
            "postal_code": "217548602",
            "telephone_number": "301-281-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MARRIAGE AND FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "BRY",
        "authorized_official_first_name": "LESLEE",
        "authorized_official_middle_name": "SOPHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-514-8120",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "LCM570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Ijamsville, MD
• Providers in Ijamsville, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.