NPIMap

Organization Active NPI

Mindfully, LLC

  • Counselor
  • Austin, TX
National Provider Identifier
1578286506
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
MINDFULLY, LLC
Practice address
2025 Guadalupe St Ste 260
Austin, TX 78705-5642
Phone
(888) 830-0347
NPI assigned
Sep 23, 2022
Organization subpart
Yes
Parent organization
MINDFULLY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Charles K Roberts, EDD, LPCC-S, LICDC-C
Title
Authorized Official
Phone
(888) 830-0347

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X

Addresses

Primary practice location

2025 Guadalupe St Ste 260
Austin, TX 78705-5642

Mailing address

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone (888) 830-0347

Other practice location 1

8500 N Mopac Expy Ste 402
Austin, TX 78759-8347
Phone (512) 902-3282

Other practice location 2

302 N Heatherwilde Blvd Ste 300
Pflugerville, TX 78660-3677
Phone (512) 902-3282

National Provider Directory

National Provider Directory
Tax ID family
Mindfully LLC - Lexington11 organizations share this tax ID, including this one
Part of
Mindfully LLC - Lexington

Other organizations with this tax ID 10

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

Locations

302 N Heatherwilde Blvd
Ste 300
Pflugerville, TX 78660
Phone (512) 902-3282

Practitioners & affiliated clinicians

Practitioners 2

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": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1578286506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "888-830-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GUADALUPE ST STE 260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787055642",
            "telephone_number": "888-830-0347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8500 N Mopac Expy Ste 402",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787598347",
            "country_code": "US",
            "telephone_number": "512-902-3282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 N Heatherwilde Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Pflugerville",
            "state": "TX",
            "postal_code": "786603677",
            "country_code": "US",
            "telephone_number": "512-902-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFULLY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINDFULLY, LLC",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "888-830-0347",
        "authorized_official_credential": "EDD, LPCC-S, LICDC-C"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.