NPIMap

Organization Active NPI

Mindful Awakening, PLLC

  • Clinical Social Worker
  • Chapel Hill, NC
National Provider Identifier
1720344740
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C003625 Issued in NC
Legal business name
MINDFUL AWAKENING, PLLC
Practice address
1703 Legion Rd
Suite 204
Chapel Hill, NC 27517-2359
Phone
(919) 960-1088
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Ms. Kate A Gotelli, LCSW
Title
Owner
Phone
(919) 960-1088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C003625 NC Primary

Addresses

Primary practice location

1703 Legion Rd
Suite 204
Chapel Hill, NC 27517-2359

Mailing address

1703 Legion Rd
Suite 204
Chapel Hill, NC 27517-2359
Phone (919) 960-1088

National Provider Directory

National Provider Directory

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": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1720344740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 LEGION RD",
            "address_2": "SUITE 204",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172359",
            "telephone_number": "919-960-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 LEGION RD",
            "address_2": "SUITE 204",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172359",
            "telephone_number": "919-960-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL AWAKENING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "GOTELLI",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-960-1088",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.