Mind Body Integrated Therapy, LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

MIND BODY INTEGRATED THERAPY, LLC

Practice address

121 N State St Ste 2
Monticello, IL 61856-1677

Phone

(217) 840-5106

NPI assigned

Mar 5, 2022

Organization subpart

No

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

Authorized official

Name

Sara Whalen, LCSWNPI 1245901305

Title

Owner

Phone

(217) 840-5106

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.

• Sara Beth Whalen, LCSW

  • Clinical Social Worker
  • Monticello, IL
  • NPI 1245901305
  NPD Authorized official

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

{
    "created_epoch": "1646438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1487301891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618560542",
            "telephone_number": "217-840-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N STATE ST STE 2",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618561677",
            "telephone_number": "217-840-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY INTEGRATED THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-05",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "WHALEN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-840-5106",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny McFarlin, PA
• Elizabeth D McGarry
• Jennifer N Meinhart, NP
• Melissa Schumacher Nutrition Therapy LLC
• Louanna Werchan Miller, LPC
• Zeinab Hani Mohsen, PHARMD
• Monticello Comm Unit SD 25
• Monticello Drugs, Inc
• Teresa L Nayden, PTA
• Brooke E Nicol, LCSW

• Social Worker in Monticello, IL
• Providers in Monticello, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.