Mind Body Soulutions, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801096853 Issued in MI

Legal business name

MIND BODY SOULUTIONS, LLC

Practice address

5242 Plainfield Ave NE
Grand Rapids, MI 49525-1084

Phone

(616) 613-6130

NPI assigned

Oct 22, 2016

Organization subpart

No

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

Authorized official

Name

Anyssa Grendel, LMSW

Title

Licensed Masters Social Worker

Phone

(616) 240-4685

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1477094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1609327808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251084",
            "telephone_number": "616-613-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5242 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251084",
            "telephone_number": "616-613-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SOULUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-22",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "GRENDEL",
        "authorized_official_first_name": "ANYSSA",
        "authorized_official_title_or_position": "LICENSED MASTERS SOCIAL WORKER",
        "authorized_official_telephone_number": "616-240-4685",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 INDIVIDUAL NPI NUMBER",
            "identifier": "1598157612",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danyell Milton, LMSW
• Jiangyong Min, MD
• Khanye Minard
• Scott Robert Minard II
• Keith Minbiole
• Mind Renewal Counseling Services, LLC
• Kathy Sue Mindes, RN
• Rachel Anne Mindes, LMSW
• Mindful Caring Transport LLC
• Mindful Growth

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.