Organization Active NPI

Mind Body Soul Marriage and Family Therapy PLLC

  • Marriage & Family Therapist
  • Rocky Point, NY
National Provider Identifier
1710864996
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MIND BODY SOUL MARRIAGE AND FAMILY THERAPY PLLC
Practice address
678 N Country Rd Unit 181
Rocky Point, NY 11778-9096
Phone
(929) 260-0268
NPI assigned
Aug 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Cortnie Valle, LMFTNPI 1780459529
Title
Owner
Phone
(929) 260-0268

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
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

678 N Country Rd Unit 181
Rocky Point, NY 11778-9096

Mailing address

678 N Country Rd Unit 181
Rocky Point, NY 11778-9096
Phone (929) 260-0268

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251212000851 NY Part B Supplier - Clinic/Group Practice 7012401482 Receives reassigned benefits from 1 practitioner
Practice locations: Central Islip, NY

National Provider Directory

National Provider Directory

Locations

678 N Country Rd
Unit 181
Rocky Point, NY 11778
Phone (640) 240-2603

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": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1710864996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 N COUNTRY RD UNIT 181",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789096",
            "telephone_number": "929-260-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 N COUNTRY RD UNIT 181",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789096",
            "telephone_number": "929-260-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SOUL MARRIAGE AND FAMILY THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "VALLE",
        "authorized_official_first_name": "CORTNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "929-260-0268",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Point, NY

Sources for this page

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