Organization Active NPI

Mindful Living Counseling, LLC

  • Clinical Social Worker
  • Westminster, MD
National Provider Identifier
1669029666
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL LIVING COUNSELING, LLC
Practice address
904 Washington Rd Ste D
Westminster, MD 21157-5838
Phone
(443) 789-6277
NPI assigned
Aug 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Authorized official

Name
Kristin Allen, LCSW-CNPI 1083024764
Title
Owner
Phone
(443) 789-6277

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: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

904 Washington Rd Ste D
Westminster, MD 21157-5838

Mailing address

904 Washington Rd Ste D
Westminster, MD 21157-5838
Phone (443) 789-6277

Other identifiers 1

IdentifierTypeStateIssuer
777635701MedicaidMD

Other names 1

  • Mindful Living Counseling, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190906001242 MD Part B Supplier - Clinic/Group Practice 9830428408 Receives reassigned benefits from 3 practitioners
Practice locations: Westminster, MD

National Provider Directory

National Provider Directory

Locations

1643 Liberty Rd
Ste 105
Sykesville, MD 21784
Phone (443) 920-5333

904 Washington Rd
Ste D
Westminster, MD 21157
Phone (410) 876-8780

Practitioners & affiliated clinicians

Practitioners 3

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": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1669029666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON RD STE D",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575838",
            "telephone_number": "443-789-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON RD STE D",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575838",
            "telephone_number": "443-789-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LIVING COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-789-6277",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777635701",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Living Counseling, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindful Living Counseling, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.