Organization Active NPI

Mind Works Therapy PLLC

Doing business as Mind Works Psychologists

  • Psychologist
  • Pass Christian, MS
National Provider Identifier
1629601927
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MIND WORKS THERAPY PLLC
Doing business as
Mind Works Psychologists
Practice address
213 Henderson Ave
Pass Christian, MS 39571-4309
Phone
(228) 300-8819
Fax
(601) 401-4289
NPI assigned
Feb 15, 2020
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Dr. Kristi W Mong, PHDNPI 1821654807
Title
Psychologist
Phone
(228) 563-4006

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
Psychologist 103T00000X Primary

Addresses

Primary practice location

213 Henderson Ave
Pass Christian, MS 39571-4309

Mailing address

213 Henderson Ave
Pass Christian, MS 39571-4309
Phone (228) 300-8819

Other identifiers 1

IdentifierTypeStateIssuer
009075709MedicaidMS

Other names 1

  • Mind Works Psychologists Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info@mindworkspsychologists.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210112002973 MS Part B Supplier - Clinic/Group Practice 8325451321 Receives reassigned benefits from 5 practitioners
Practice locations: Pass Christian, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1629601927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 HENDERSON AVE",
            "city": "PASS CHRISTIAN",
            "state": "MS",
            "postal_code": "395714309",
            "telephone_number": "228-300-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 HENDERSON AVE",
            "city": "PASS CHRISTIAN",
            "state": "MS",
            "postal_code": "395714309",
            "telephone_number": "228-300-8819",
            "fax_number": "601-401-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND WORKS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-15",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "MONG",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "228-563-4006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009075709",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@mindworkspsychologists.com",
            "affiliation": "N",
            "address_1": "24505 Mare Point Dr",
            "city": "Pass Christian",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395713302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mind Works Psychologists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mind Works Psychologists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pass Christian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.