Mindful Journey Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL JOURNEY THERAPY LLC

Practice address

3441 Colonial Blvd Ste 2&3
Fort Myers, FL 33966-1121

Phone

(770) 366-6898

Fax

(239) 800-5145

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Patricia E Sullivan, LCSWNPI 1053038661

Title

Owner

Phone

(770) 366-6898

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.

• Patricia Ellen Sullivan

  • Clinical Social Worker
  • Fort Myers, FL
  • NPI 1053038661
  NPD Authorized official

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1598473902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 COLONIAL BLVD STE 2&3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661121",
            "telephone_number": "941-216-6111",
            "fax_number": "239-244-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 COLONIAL BLVD STE 2&3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661121",
            "telephone_number": "770-366-6898",
            "fax_number": "239-800-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL JOURNEY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-366-6898",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven C Mims, CRNA
• Bassem M Mina
• John W Mina, DPM
• Cecilia Minano, M.D., M.P.H.
• Mind and Brain Care LLC
• Moira V. Miner, RN
• Dana Dale Minick
• Robert Keith Minkes, M.D.
• Ashley Marie Minor, PA
• Jacques Hector Minville, M.D.

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.