Mindful Solutions PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0480000729 Issued in VT

Legal business name

MINDFUL SOLUTIONS PLLC

Practice address

160 Benmont Ave
Suite 20
Bennington, VT 05201-1873

Phone

(802) 442-3520

NPI assigned

Jun 22, 2010

Organization subpart

No

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

Authorized official

Name

Lisa PezzulichNPI 1417040767

Title

Owner

Phone

(802) 442-3520

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa M Pezzulich, PSY.D.

  • Clinical Psychologist
  • Bennington, VT
  • NPI 1417040767
  Medicare reassignment Care Compare group Authorized official
• Robert Charles Hemmer, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Manchester Center, VT
  • NPI 1134132053
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1740501071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 COBBLE HL",
            "city": "SHAFTSBURY",
            "state": "VT",
            "postal_code": "052629241",
            "telephone_number": "802-442-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BENMONT AVE",
            "address_2": "SUITE 20",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011873",
            "telephone_number": "802-442-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "PEZZULICH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-442-3520"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "0480000729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Merges, MA
• MHP Healthcare LLC (Extended Care Pharmacy LLC)
• Whitney P Mical, FNP
• Diana Michalczuk, PSYD
• Robert J Miller, D.D.S.
• Wanda Christine Minenna, NP
• Katherine Miskovsky, M.ED.
• Mackenzie Lucille Mitchell
• Gary Moelich, AA
• Kimberley Monnet

• Clinical Psychologist in Bennington, VT
• Providers in Bennington, VT by specialty
• Clinical Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.