Integrating Body Mind and Life, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INTEGRATING BODY MIND AND LIFE, LLC

Doing business as

Ibml, LLC

Practice address

2302 Parklake Drive NE
Suite 425
Atlanta, GA 30345-2966

Phone

(678) 612-5587

Fax

(866) 261-5260

NPI assigned

Feb 18, 2008

Last updated

Aug 14, 2025By 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

Ms. Mireille Etienne, LPC, LMHC

Title

Owner

Phone

(678) 612-5587

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• IBML, LLC Doing business as
• IBML. LLC. Other name

Locations

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1750559217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 PARKLAKE DRIVE NE",
            "address_2": "SUITE 425",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452966",
            "telephone_number": "678-612-5587",
            "fax_number": "866-261-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 PARKLAKE DRIVE NE",
            "address_2": "SUITE 425",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452966",
            "telephone_number": "678-612-5587",
            "fax_number": "866-261-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATING BODY MIND AND LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "MIREILLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-612-5587",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11824149",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "476557646A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IBML, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IBML. LLC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.