Mindful Balance Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MINDFUL BALANCE THERAPY LLC

Practice address

3208 Whitney Ave Ste 1a
Hamden, CT 06518-2158

Phone

(475) 477-4190

NPI assigned

Apr 1, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole Ann Wetmore, LPCNPI 1639449499

Title

Licensed Mental Health Therapist

Phone

(475) 477-4190

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nicole Ann Wetmore, M.S.

  • Counselor
  • New Haven, CT
  • NPI 1639449499
  NPD Authorized official

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1558113902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WOODS RD",
            "city": "BETHANY",
            "state": "CT",
            "postal_code": "065243103",
            "telephone_number": "203-605-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 WHITNEY AVE STE 1A",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182158",
            "telephone_number": "475-477-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL BALANCE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "WETMORE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "475-477-4190",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perry Miller
• Rebecca Culler Miller, L.C.S.W.
• Robert Harold Miller
• Ellen Block Milstone, M.D.
• Martenia Mims, LPN BSHCM MSHS
• Alexandra Marvel Miranda-Castillo, LMFT
• Danielle Kristen Miranda
• Diane Karen Mital
• Hayes Mitchell, LPCA
• Ruth-Ann Mitchell, MEDICAL LAB

• Professional Counselor in Hamden, CT
• Providers in Hamden, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.