Organization Active NPI

Mind Align Integrative, Inc

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1619853058
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MIND ALIGN INTEGRATIVE, INC
Practice address
1830 Sherman Ave Ste 401
Evanston, IL 60201-3774
Phone
(847) 852-7496
Fax
(870) 206-8213
NPI assigned
Aug 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Authorized official

Name
Amanda EmersonNPI 1659701654
Title
President
Phone
(847) 852-7496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1830 Sherman Ave Ste 401
Evanston, IL 60201-3774

Mailing address

1830 Sherman Ave Ste 401
Evanston, IL 60201-3774
Phone (847) 852-7496

Other names 1

  • Mind Align Integrative Health and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260407002940 IL Part B Supplier - Clinic/Group Practice 6608341698 Receives reassigned benefits from 1 practitioner
Practice locations: Evanston, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788739200000",
    "number": "1619853058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 SHERMAN AVE STE 401",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013774",
            "telephone_number": "847-852-7496",
            "fax_number": "870-206-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 SHERMAN AVE STE 401",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013774",
            "telephone_number": "847-852-7496",
            "fax_number": "870-206-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND ALIGN INTEGRATIVE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-852-7496"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind Align Integrative Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; 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.