Mindful Blujay Therapeutics LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL BLUJAY THERAPEUTICS LLC

Practice address

4551 Barrington LN
Niceville, FL 32578-8793

Phone

(850) 462-3786

NPI assigned

Dec 28, 2021

Organization subpart

No

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

Authorized official

Name

Venusia Martinez, LCSWNPI 1568779502

Title

Owner

Phone

(850) 462-3786

Specialties & licenses 1

Addresses

Other names 1

• Venusia Martinez Doing business as

Locations

Practitioners 1

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

• Venusia Martinez, LCSW

  • Social Worker
  • Niceville, FL
  • NPI 1568779502
  NPD Authorized official

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1407516701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 E HIGHWAY 20 # 3015",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789755",
            "telephone_number": "850-462-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 BARRINGTON LN",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788793",
            "telephone_number": "850-462-3786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4551 Barrington Ln",
            "address_purpose": "LOCATION",
            "city": "Niceville",
            "state": "FL",
            "postal_code": "325788793",
            "country_code": "US",
            "telephone_number": "850-462-3786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL BLUJAY THERAPEUTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-28",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "VENUSIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-462-3786",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Venusia Martinez",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Miller
• Elizabeth Mills
• Karyn Mills, RBT
• Patrick Mills, BCABA
• Alexious Milord, MSW
• Kenneth Paul Mitchell, MD
• Terence Burrell Mitchell, M.D.
• Cailie Mlynarski
• Jessica Michelle Moore, MS, NCC, LMHC
• Jeremy Harrison Morris, FNP-C, APRN

• Clinical Social Worker in Niceville, FL
• Providers in Niceville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.