NPIMap

Organization Active NPI

Mind & Body Healing Collective, LLC

  • Clinical Social Worker
  • Lawrence, KS
National Provider Identifier
1568196459
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MIND & BODY HEALING COLLECTIVE, LLC
Practice address
2619 W 6TH St Ste C
Lawrence, KS 66049-4300
Phone
(785) 917-9473
NPI assigned
Jul 15, 2022
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Maisie Riley
Title
Manager
Phone
(785) 917-9473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2619 W 6TH St Ste C
Lawrence, KS 66049-4300

Mailing address

2619 W 6TH St Ste C
Lawrence, KS 66049-4300
Phone (785) 917-9473

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221206001209 KS Part B Supplier - Clinic/Group Practice 7416326962 Receives reassigned benefits from 17 practitioners
Practice locations: Lawrence, KS

National Provider Directory

National Provider Directory

Locations

2512 W 6th St
Ste C
Lawrence, KS 66049
Phone (785) 856-6789

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1568196459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 W 6TH ST STE C",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494300",
            "telephone_number": "785-917-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 W 6TH ST STE C",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494300",
            "telephone_number": "785-917-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & BODY HEALING COLLECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-15",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "MAISIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "785-917-9473"
    },
    "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 Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.