The Grounded Mind Therapy and Consultation, L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE GROUNDED MIND THERAPY AND CONSULTATION, L.L.C.

Doing business as

Chastidy Boutin

Practice address

1817 Green Cir
Valdosta, GA 31602-2885

Phone

(229) 244-9688

NPI assigned

Jan 2, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Chastidy Boutin, LCSWNPI 1447916333

Title

Owner/Operator

Phone

(706) 341-2745

Specialties & licenses 1

Addresses

Other names 1

• Chastidy Boutin Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

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

• Chastidy Boutin

  • Social Worker
  • Valdosta, GA
  • NPI 1447916333

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1548079700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022885",
            "telephone_number": "229-244-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GROUNDED MIND THERAPY AND CONSULTATION, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "BOUTIN",
        "authorized_official_first_name": "CHASTIDY",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "706-341-2745",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chastidy Boutin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.