Mindfully Whole Psychotherapy LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

2016005653 Issued in MO

Legal business name

MINDFULLY WHOLE PSYCHOTHERAPY LLC

Practice address

4057 W Ildereen St
Springfield, MO 65807-1063

Phone

(417) 413-4991

Fax

(417) 719-7995

NPI assigned

Jan 19, 2017

Last updated

Feb 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Barbara Manzer Farrell, PSYD

Title

Owner

Phone

(417) 413-4991

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1689111379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 W ILDEREEN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658071063",
            "telephone_number": "417-413-4991",
            "fax_number": "417-719-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 W ILDEREEN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658071063",
            "telephone_number": "417-413-4991",
            "fax_number": "417-719-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULLY WHOLE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "MANZER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-413-4991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MO",
            "license": "2016005653",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MO",
            "license": "2016005653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark J Milne, M.D.
• Ivan Eugene Milton, AT
• Rebecca Milton, RDN, LD
• Andrew J. Minard, D,C.
• Mind Melding LLC (Mind Melding Counseling)
• Mindsmattersmd LLC
• Laura Minehart, DDS
• Kaylee J Miner, LMSW
• Patricia L Mingus, MS LPC
• Minirth Skipper Clinic (Minirth Skipper Counseling Clinic)

• Adolescent and Children Mental Health Clinic/Center in Springfield, MO
• Providers in Springfield, MO by specialty
• Adolescent and Children Mental Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.