Mindful Motion Therapy, LLC.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MINDFUL MOTION THERAPY, LLC.

Doing business as

Mindful Motion Therapy

Practice address

20 Avon Meadow LN Ste 210
Avon, CT 06001-3731

Phone

(860) 881-5755

NPI assigned

Mar 11, 2021

Organization subpart

No

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

Authorized official

Name

Stacy M Wilcox, DOT, MOTNPI 1134365240

Title

Occupational Therapist

Phone

(860) 881-5755

Specialties & licenses 2

Addresses

Other names 1

• Mindful Motion Therapy Doing business as

Locations

Practitioners 1

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

• Stacy M Wilcox, OT

  • Occupational Therapist
  • Avon, CT
  • NPI 1134365240
  NPD Authorized official

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1528643459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FERNWOOD DR",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060702902",
            "telephone_number": "860-881-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 AVON MEADOW LN STE 210",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013731",
            "telephone_number": "860-881-5755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 N Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "Newington",
            "state": "CT",
            "postal_code": "061111424",
            "country_code": "US",
            "telephone_number": "860-940-2413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL MOTION THERAPY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-11",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "860-881-5755",
        "authorized_official_credential": "DOT, MOT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Motion Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindful Motion Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Metcalf, M.S., CCC-SLP
• Tashia Michaud
• Eileen Mary Miller, APRN
• Kathryn E Miller, MSPT
• Naima R Millette, PT
• Mindful Vision Counseling
• Jennifer Anne Miner
• Mohsin Mirza
• Mitchell S Katz DDS and Associates, PC
• Fawzu Fusaini Mohammadu, MD

• Clinic/Center in Avon, CT
• Providers in Avon, CT by specialty
• Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.