Mademind Wellness & Performance

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MADEMIND WELLNESS & PERFORMANCE

Practice address

3402 Chesterfield CT
Snellville, GA 30039-4609

Phone

(206) 734-0964

NPI assigned

Apr 2, 2025

Organization subpart

No

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

Authorized official

Name

Michael Wiley Jr., LCPCNPI 1508487976

Title

Owner

Phone

(206) 734-0964

Specialties & licenses 1

Addresses

Practitioners 1

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

• Michael Wiley Jr., LCPC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1508487976
  NPD Authorized official

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1700680394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7234 W NORTH AVE STE 208",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607074202",
            "telephone_number": "206-734-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 CHESTERFIELD CT",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394609",
            "telephone_number": "206-734-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADEMIND WELLNESS & PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-734-0964",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Macauley, M.S., NCC, LPC
• Marissa Allen Macdonald
• Laura Maclaren, ATC
• Karen Macnamee
• Stanford James Maddox
• Wilfrido Matinezo Magat, M.D.
• Magz Health Services, Inc.
• Mahon Family Medicine
• Thomas M Mahon, MD
• Thomas M Mahon Jr., O.D.

• Mental Health Counselor in Snellville, GA
• Providers in Snellville, GA by specialty
• Mental Health Counselor in Georgia

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