Organization Active NPI

Mindful Clinical Services, LLC

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1548901317
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL CLINICAL SERVICES, LLC
Practice address
1923 Westwood Blvd Ste 4
Los Angeles, CA 90025-4613
Phone
(747) 228-2621
NPI assigned
Apr 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Samantha Wakach, LCSWNPI 1720126832
Title
Co-Founder
Phone
(747) 228-2621

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 WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1923 Westwood Blvd Ste 4
Los Angeles, CA 90025-4613

Mailing address

1923 Westwood Blvd Ste 4
Los Angeles, CA 90025-4613
Phone (747) 228-2621

National Provider Directory

National Provider Directory
Tax ID family
Mindful Clinical Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1923 Westwood Blvd
Ste 4
Los Angeles, CA 90025
Phone (747) 228-2621

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": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1548901317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 WESTWOOD BLVD STE 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254613",
            "telephone_number": "747-228-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 WESTWOOD BLVD STE 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254613",
            "telephone_number": "747-228-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL CLINICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "WAKACH",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "747-228-2621",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.