Organization Active NPI

Mindful Matters Therapy LLC

  • Clinical Social Worker
  • Earlville, IL
National Provider Identifier
1548082373
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL MATTERS THERAPY LLC
Practice address
374 Hedge Rd
Earlville, IL 60518-7021
Phone
(815) 793-3742
NPI assigned
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Loni NolteNPI 1740769298
Title
Owner
Phone
(815) 793-3742

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

374 Hedge Rd
Earlville, IL 60518-7021

Mailing address

374 Hedge Rd
Earlville, IL 60518-7021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250128001430 IL Part B Supplier - Clinic/Group Practice 7315476900 Receives reassigned benefits from 1 practitioner
Practice locations: Rochelle, IL; Earlville, IL

National Provider Directory

National Provider Directory

Locations

516 4th Ave
Rochelle, IL 61068
Phone (815) 508-8511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1548082373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 HEDGE RD",
            "city": "EARLVILLE",
            "state": "IL",
            "postal_code": "605187021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 HEDGE RD",
            "city": "EARLVILLE",
            "state": "IL",
            "postal_code": "605187021",
            "telephone_number": "815-793-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MATTERS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "NOLTE",
        "authorized_official_first_name": "LONI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-793-3742"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Earlville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.