Peaceful Mind Wise Heart DBT PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

PEACEFUL MIND WISE HEART DBT PLLC

Practice address

720 N Main St Ste 240
Pueblo, CO 81003-3046

Phone

(719) 994-7643

Fax

(855) 775-0361

NPI assigned

Aug 20, 2024

Organization subpart

No

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

Authorized official

Name

Angela Maria Calderon, LPCNPI 1598280257

Title

Owner

Phone

(716) 994-7643

Specialties & licenses 1

Addresses

Practitioners 1

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

• Angela Maria Calderon, LPC

  • Professional Counselor
  • Pueblo, CO
  • NPI 1598280257
  NPD Authorized official

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1487487146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N MAIN ST STE 240",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033046",
            "telephone_number": "719-994-7643",
            "fax_number": "855-775-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N MAIN ST STE 240",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033046",
            "telephone_number": "719-994-7643",
            "fax_number": "855-775-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL MIND WISE HEART DBT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-994-7643",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.