Mindful Clinic

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

MINDFUL CLINIC

Practice address

2712 Middleburg Dr
Suite 104
Columbia, SC 29204-2415

Phone

(919) 697-0767

NPI assigned

Nov 30, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Akila Proctor

Title

Ceo

Phone

(919) 697-0767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1457725558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 MIDDLEBURG DR",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042415",
            "telephone_number": "919-697-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 MIDDLEBURG DR",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042415",
            "telephone_number": "919-697-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "AKILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-697-0767",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Renee Mincey, LPC
• Mind Haven Psychiatry
• Mindful Authority
• Mindful Behavioral, Inc
• Mindful Behavioral, Inc
• Erin Mines, RBT
• Balbir Singh Minhas, MD
• Patrick Minnick
• Demerise Ott Minor, FNP
• Tomas Minor, PH.D.

• Addiction (Substance Use Disorder) Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Addiction (Substance Use Disorder) Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.