Active NPI
Mindful Therapy Solutions LCSW PLLC
- Clinical Social Worker
- Staten Island, NY
National Provider Identifier
1578999546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 079574
- Legal business name
- MINDFUL THERAPY SOLUTIONS LCSW PLLC
- Practice address
- 12 Jefferson Blvd Ste 2
Staten Island, NY 10312-3330 - Phone
- (718) 966-0317
- Fax
- (917) 791-8248
- NPI assigned
- Sep 22, 2013
- Last updated
- Dec 1, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elissa Donner
- Title
- Owner/LCSW
- Phone
- (718) 966-0317
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 079574 | NY | Primary |
Addresses
Primary practice location
12 Jefferson Blvd Ste 2
Staten Island, NY 10312-3330
Mailing address
12 Jefferson Blvd Ste 2
Staten Island, NY 10312-3330
Phone (718) 966-0317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
12 Jefferson Blvd
Ste 2
Staten Island, NY 10312
Phone (718) 500-1726
1749 Victory Blvd
Ste 2
Staten Island, NY 10314
Phone (718) 608-5651
Practitioners & affiliated clinicians
Practitioners 8
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.
-
- Clinical Social Worker
- Staten Island, NY
- NPI 1093070872
-
- Mental Health Counselor
- Staten Island, NY
- NPI 1831713296
-
- Mental Health Counselor
- Staten Island, NY
- NPI 1689298044
-
- Clinical Social Worker
- Staten Island, NY
- NPI 1215626247
-
- Social Worker
- Staten Island, NY
- NPI 1932478948
-
- Mental Health Counselor
- Staten Island, NY
- NPI 1881864478
Single Specialty
-
- Marriage & Family Therapist
- Staten Island, NY
- NPI 1912571787
-
- Psychiatric/Mental Health Clinical Nurse Specialist
- Staten Island, NY
- NPI 1437250206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379808000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764547200000",
"number": "1578999546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 JEFFERSON BLVD STE 2",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103123330",
"telephone_number": "718-966-0317",
"fax_number": "917-791-8248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 JEFFERSON BLVD STE 2",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103123330",
"telephone_number": "718-966-0317",
"fax_number": "917-791-8248"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDFUL THERAPY SOLUTIONS LCSW PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-09-22",
"last_updated": "2025-12-01",
"certification_date": "2025-12-01",
"status": "A",
"authorized_official_last_name": "DONNER",
"authorized_official_first_name": "ELISSA",
"authorized_official_title_or_position": "OWNER/LCSW",
"authorized_official_telephone_number": "718-966-0317"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "079574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.