Mindful Path Behavioral Health and Wellness, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.007542 Issued in IL

Legal business name

MINDFUL PATH BEHAVIORAL HEALTH AND WELLNESS, INC.

Practice address

53 W Jackson Blvd
Suite 1111
Chicago, IL 60604-3606

Phone

(847) 224-5282

NPI assigned

Dec 27, 2012

Last updated

Dec 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jabriel Rose, PSY.D.NPI 1265661805

Title

President and Treasurer

Phone

(847) 224-5282

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, and the practitioner matching its NPPES authorized official.

• Jabriel Rose, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1265661805
  NPD (past) Authorized official

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1558607226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD",
            "address_2": "SUITE 1111",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043606",
            "telephone_number": "847-224-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD",
            "address_2": "SUITE 1111",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043606",
            "telephone_number": "847-224-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL PATH BEHAVIORAL HEALTH AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "JABRIEL",
        "authorized_official_title_or_position": "PRESIDENT AND TREASURER",
        "authorized_official_telephone_number": "847-224-5282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Mattering PLLC
• Mindful Matters Clinical Counseling
• Mindful Minute Therapy LLC
• Mindful Moments Therapy LLC
• Mindful Movement Counseling
• Mindful Peace and Restoration, LLC
• Mindful Shift Therapy, PLLC
• Mindful Steps LLC
• Mindful Therapy & Wellness, PLLC (Mindful Therapy & Wellness)
• Mindful Therapy Solutions LLC

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.