Organization Active NPI

Mindful Connections Counseling LLC

  • Clinical Social Worker
  • Kalispell, MT
National Provider Identifier
1558814525
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL CONNECTIONS COUNSELING LLC
Practice address
428 1St Ave W
Kalispell, MT 59901-4836
Phone
(406) 298-3632
Fax
(406) 890-6835
NPI assigned
Jul 26, 2016
Last updated
Jul 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Shelly May, LCSW, LACNPI 1497901060
Title
Owner
Phone
(406) 697-7912

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

428 1St Ave W
Kalispell, MT 59901-4836

Mailing address

428 1St Ave W
Kalispell, MT 59901-4836
Phone (406) 298-3632

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190307001309 MT Part B Supplier - Clinic/Group Practice 0941549026 Receives reassigned benefits from 1 practitioner
Practice locations: Kalispell, MT

National Provider Directory

National Provider Directory

Locations

115 Commons Way
Ste 201
Kalispell, MT 59901
Phone (406) 298-3632

307 1st Ave E
Ste 214
Kalispell, MT 59901
Phone (406) 261-5005

Practitioners & affiliated clinicians

Practitioners 4

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": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1558814525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 1ST AVE W",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014836",
            "telephone_number": "406-298-3632",
            "fax_number": "406-890-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 1ST AVE W",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014836",
            "telephone_number": "406-298-3632",
            "fax_number": "406-890-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL CONNECTIONS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-697-7912",
        "authorized_official_credential": "LCSW, LAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.