Mind Body Soul Counseling Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MIND BODY SOUL COUNSELING SERVICES, LLC

Practice address

305 Prism Dr.
Carrollton, GA 30116-5596

Phone

(610) 751-1975

NPI assigned

Aug 12, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Tonya Diane Klemmer

Title

Owner

Phone

(610) 751-1975

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1700432184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 PRISM DR.",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301165596",
            "telephone_number": "610-751-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 PRISM DR.",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301165596",
            "telephone_number": "610-751-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SOUL COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "KLEMMER",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-751-1975",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randi Danielle Miley
• Jack W Miller, M.D
• Lauren Elizabeth Miller
• Sydney Danielle Miller
• John Michael Mills, DMD
• Keri L Minton, PA
• Jesse Mitchell Jr., M.D.
• Kadie Michelle Mitchell, PT, DPT
• Patricia Mitchell
• Juliet Njideka Mkpuechina

• Mental Health Clinic/Center (Including Community Mental Health Center) in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.