The Delaware Center for Mindfulness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE DELAWARE CENTER FOR MINDFULNESS, LLC

Practice address

2607 N Harrison St
Wilmington, DE 19802-2922

Phone

(302) 307-1779

NPI assigned

Jan 4, 2022

Organization subpart

No

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

Authorized official

Name

Lisa Tanner

Title

Credentialing Specialist

Phone

(302) 803-0119

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William B McCracken, LCSW,ICADC

  • Clinical Social Worker
  • Wilmington, DE
  • NPI 1003586710
  Medicare reassignment
• Jennifer L Tedesco, PSYD

  • Clinical Psychologist
  • Byram Township, NJ
  • NPI 1992730022
  NPD

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1700547650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 FINGERBOARD SCHOOLHOUS RD",
            "city": "EARLEVILLE",
            "state": "MD",
            "postal_code": "219191420",
            "telephone_number": "302-307-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 N HARRISON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022922",
            "telephone_number": "302-307-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DELAWARE CENTER FOR MINDFULNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "302-803-0119"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "delawarecfm@gmail.com",
            "affiliation": "N",
            "address_1": "2607 N Harrison St",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198022922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Clinical Social Worker in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.