Organization Active NPI

Mindspa Wellness Clinic LLC

Doing business as Mindspa Wellness Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1699553859
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDSPA WELLNESS CLINIC LLC
Doing business as
Mindspa Wellness Clinic
Practice address
90 Madison St Ste 500
Worcester, MA 01608-2077
Phone
(508) 762-6586
NPI assigned
Sep 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Beth Harden, AGPCNP-BCNPI 1649604133
Title
Nurse Practitioner
Phone
(508) 762-6586

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

90 Madison St Ste 500
Worcester, MA 01608-2077

Mailing address

90 Madison St Ste 500
Worcester, MA 01608-2077
Phone (508) 762-6586

Other names 1

  • Mindspa Wellness Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240208001524 MA Part B Supplier - Clinic/Group Practice 2466895222 Receives reassigned benefits from 1 practitioner
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

23 Harvard St
Worcester, MA 01609
Phone (508) 890-5633

23 Harvard St
#200
Worcester, MA 01609
Phone (978) 955-7660

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": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1699553859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MADISON ST STE 500",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082077",
            "telephone_number": "508-762-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MADISON ST STE 500",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082077",
            "telephone_number": "508-762-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSPA WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-09-02",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "HARDEN",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "508-762-6586",
        "authorized_official_credential": "AGPCNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindspa Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.