Mind Body Connection LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3021 Issued in TN

Legal business name

MIND BODY CONNECTION LLC

Practice address

1422 Knight Dr
Murfreesboro, TN 37128-6760

Phone

(615) 369-9897

Fax

(888) 782-8545

NPI assigned

Jan 5, 2016

Organization subpart

No

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

Authorized official

Name

Christine Robertini, LPC-MHSP NCC

Title

Ceo/President

Phone

(615) 369-9897

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1508222688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330931",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371330931",
            "telephone_number": "615-369-9897",
            "fax_number": "888-782-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 KNIGHT DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371286760",
            "telephone_number": "615-369-9897",
            "fax_number": "888-782-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY CONNECTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "ROBERTINI",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "615-369-9897",
        "authorized_official_credential": "LPC-MHSP NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TN",
            "license": "3021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016682",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad E Mills, PHARM.D.
• Kendall Renee Mills
• Rebecca Mills, PHARMD
• Russell Henry Mills, PH.D.
• Teyiena Kimbriel Mims, MSN, APRN, PMHNP
• Mindful Haven Mental Health Services
• Caleb David Miner, P.A.-C
• Patricia Minerd
• Ryan Minyard
• Guy Britton Mioton, MD

• Community/Behavioral Health Agency in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Community/Behavioral Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.