Modern Mindwork, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MODERN MINDWORK, LLC

Practice address

1313 E Maple St # 107
Bellingham, WA 98225-5708

Phone

(509) 405-1001

NPI assigned

Jan 4, 2024

Organization subpart

No

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

Authorized official

Name

Joanna Starratt, MSN CRNA ARNP

Title

Clinical Director

Phone

(509) 405-1001

Specialties & licenses 1

Addresses

Other names 1

• Mt Kulshan Ketamine Clinic Former legal business name

Locations

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1720858301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 E MAPLE ST # 107",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255708",
            "telephone_number": "509-405-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E MAPLE ST # 107",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255708",
            "telephone_number": "509-405-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MINDWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "STARRATT",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "509-405-1001",
        "authorized_official_credential": "MSN CRNA ARNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt Kulshan Ketamine Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Laura Melinda Mixon, M.S.
• Haley Kathleen Mladenik, LMHC
• Mohammad H Moazedi
• Mobile Mama Strategies, Inc (Mobile Mama Therapy)
• Mobile Sleep Anesthesiology (Anesthesia Mobile)
• Heidi Modin, M.A. CCC-SLP
• Ankur Mogla, MD
• Mohammad Mohiddin, M.D.
• Theodore F Molaski, PT
• Jesse C Moline, ARNP

• Community/Behavioral Health Agency in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.