The Mind Room, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE MIND ROOM, LLC

Practice address

81 Watertown St
Watertown, MA 02472-2569

Phone

(617) 818-1728

NPI assigned

Jan 19, 2021

Organization subpart

No

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

Authorized official

Name

Jessica Werner, LMHC

Title

Owner

Phone

(617) 818-1728

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1689264293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 WATERTOWN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722569",
            "telephone_number": "617-818-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 WATERTOWN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722569",
            "telephone_number": "617-818-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MIND ROOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-818-1728",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.themindroom.org",
            "affiliation": "N",
            "endpointDescription": "Secure client portal",
            "address_1": "81 Watertown St",
            "city": "Watertown",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024722569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela D Tewarson, M.D.
• Lisa A Thayer, M.D.
• The Collective We, LLC
• The Expert Ally LLC
• The Listening Room Psychological Services, PLLC
• Thomas H Gorman DC PC (Watertown Back Care)
• Brynn A Thomas, RPH
• Jean Thomas, LMHC
• Kristin Thomas
• Patrice Ann Titterington

• Mental Health Counselor in Watertown, MA
• Providers in Watertown, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.