Mind and Body Wellness

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

MIND AND BODY WELLNESS

Practice address

1300 Montauk Hwy
Oakdale, NY 11769-1339

Phone

(631) 404-6431

NPI assigned

Jul 19, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Deirdre Lee Russo, LMFTNPI 1457722464

Title

Owner

Phone

(631) 404-6431

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Deirdre Lee Russo, MFT

  • Marriage & Family Therapist
  • East Setauket, NY
  • NPI 1457722464
  NPD Authorized official

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1477233187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691339",
            "telephone_number": "631-404-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691339",
            "telephone_number": "631-404-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-404-6431",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ann Melly, PNP
• Demetrios Vasilios Mesimeris, PT, DPT, CSCS
• Karen D Middel -Jones, NP
• Barry Mildener, MD
• Alexandra Nicole Miller, LCSW
• Pamela Lauren Mitchell, PH.D.
• Michael C Moore, PTA
• Kimberly Mora, CCC-SLP
• Stephanie Moreau
• Jacqueline Morgan

• Marriage & Family Therapist in Oakdale, NY
• Providers in Oakdale, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.