Organization Active NPI

Moving Into New Dimensions Therapeutic Services LLLC

Doing business as M.I.N.D. Therapeutic Services LLC

  • Community/Behavioral Health Agency
  • Port St Lucie, FL
National Provider Identifier
1710870084
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MOVING INTO NEW DIMENSIONS THERAPEUTIC SERVICES LLLC
Doing business as
M.I.N.D. Therapeutic Services LLC
Practice address
1860 SW Fountainview Blvd Ste 79
Port St Lucie, FL 34986-4535
Phone
(772) 722-4772
NPI assigned
Jun 3, 2025
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Mrs. Latonya Denise Shaw, DHA, LMHC. EMDRNPI 1033419361
Title
Owner
Phone
(561) 294-5888

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1860 SW Fountainview Blvd Ste 79
Port St Lucie, FL 34986-4535

Mailing address

1860 SW Fountainview Blvd Ste 79
Port St Lucie, FL 34986-4535
Phone (772) 722-4772

Other names 1

  • M.I.N.D. Therapeutic Services LLC Doing business as

National Provider Directory

National Provider Directory

Locations

1860 SW Fountainview Blvd
Ste 79
Port St Lucie, FL 34986
Phone (772) 722-4772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1710870084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SW FOUNTAINVIEW BLVD STE 79",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864535",
            "telephone_number": "772-722-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 SW FOUNTAINVIEW BLVD STE 79",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864535",
            "telephone_number": "772-722-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOVING INTO NEW DIMENSIONS THERAPEUTIC SERVICES LLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-03",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "LATONYA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-294-5888",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DHA, LMHC. EMDR"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M.I.N.D. Therapeutic Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.