NPIMap

Organization Active NPI

Mindful Sport and Performance

  • Mental Health Counselor
  • Alpharetta, GA
National Provider Identifier
1508470428
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDFUL SPORT AND PERFORMANCE
Practice address
401 S Main St
Alpharetta, GA 30009-1974
Phone
(404) 783-8135
NPI assigned
Sep 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
Shena F Locke, LAPCNPI 1629666490
Title
Ceo
Phone
(404) 783-8135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Corporate Health Clinic/Center 261QC1800X
Health Service Clinic/Center 261QH0100X
Preferred Provider Organization 305R00000X

Addresses

Primary practice location

401 S Main St
Alpharetta, GA 30009-1974

Mailing address

401 S Main St
Alpharetta, GA 30009-1974
Phone (404) 783-8135

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shena@mindfulsport.net Direct
Direct Messaging Address shena@mindfulsport.net Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1508470428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091974",
            "telephone_number": "404-783-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091974",
            "telephone_number": "404-783-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL SPORT AND PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "SHENA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-783-8135",
        "authorized_official_credential": "LAPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shena@mindfulsport.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1640 Habershal Rd NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303184041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shena@mindfulsport.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 S Main St",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300091974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.