Mind, Body, and Soul Therapy LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

80925 Issued in CA

Legal business name

MIND, BODY, AND SOUL THERAPY LLC

Doing business as

Mind, Body, and Soul Therapy LLC

Practice address

2940 Summit St Ste 2E
Oakland, CA 94609-3416

Phone

(510) 473-6062

NPI assigned

Jun 5, 2018

Last updated

Jun 5, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tynisa D Snow, LCSWNPI 1487083515

Title

Member

Phone

(510) 473-6062

Specialties & licenses 1

Addresses

Other names 1

• Mind, Body, and Soul Therapy LLC Doing business as

Locations

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.

• Tynisa Darlene Snow, LCSW

  • Clinical Social Worker
  • Oakland, CA
  • NPI 1487083515
  NPD (past) Authorized official

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1730671769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945870017",
            "telephone_number": "510-473-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST STE 2E",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "510-473-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND, BODY, AND SOUL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "TYNISA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "510-473-6062",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "80925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind, Body, and Soul Therapy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ma Khine Min Naing, RN-BSN,PHN
• Andrew Min, M.D.
• Mauna Minagar, ASW
• Sara Emily Neff Minahan, CNM, WHNP, RN
• Tobia Jeanette Minckler, MS
• Mindful Birthing and Parenting Foundation
• Mindful Speech-Language Therapy, Inc.
• Mindhealth, a Professional Psychology Corporation
• Mindy Werner-Crohn, M.D., Inc, (Blue Sky Psychiatry)
• Jennifer Louise Miner

• Adult Mental Health Clinic/Center in Oakland, CA
• Providers in Oakland, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.