NPIMap

Organization Active NPI

Mindful Authenticity, LLC

  • Professional Counselor
  • Greybull, WY
National Provider Identifier
1528633625
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MINDFUL AUTHENTICITY, LLC
Practice address
3360 Road 12
Greybull, WY 82426-9624
Phone
(970) 279-1117
Fax
(970) 837-3401
NPI assigned
May 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Hali Neves, MA, LPCNPI 1073892725
Title
Founder/Owner
Phone
(970) 279-1117

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

3360 Road 12
Greybull, WY 82426-9624

Mailing address

1163 Belleview Dr
Fort Collins, CO 80526-3840
Phone (970) 279-1117

National Provider Directory

National Provider Directory
Tax ID family
Mindful Authenticity LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

323 S College Ave
Ste 3
Fort Collins, CO 80524

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": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1528633625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 BELLEVIEW DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805263840",
            "telephone_number": "970-279-1117",
            "fax_number": "970-837-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 ROAD 12",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824269624",
            "telephone_number": "970-279-1117",
            "fax_number": "970-837-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL AUTHENTICITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "NEVES",
        "authorized_official_first_name": "HALI",
        "authorized_official_title_or_position": "FOUNDER/OWNER",
        "authorized_official_telephone_number": "970-279-1117",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greybull, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.