Your Mindful Path Counseling and Yoga, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LPC007365 Issued in GA

Legal business name

YOUR MINDFUL PATH COUNSELING AND YOGA, LLC

Practice address

4562 Lawrenceville Hwy NW
Suite 123
Lilburn, GA 30047-3641

Phone

(678) 856-5079

Fax

(770) 982-2818

NPI assigned

Sep 26, 2013

Organization subpart

No

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

Authorized official

Name

Jennifer Del Castillo

Title

Owner/Counselor

Phone

(678) 856-5079

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1750718409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 SCOTLAND CT",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398454",
            "telephone_number": "678-856-5079",
            "fax_number": "770-982-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4562 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 123",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473641",
            "telephone_number": "678-856-5079",
            "fax_number": "770-982-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR MINDFUL PATH COUNSELING AND YOGA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "DEL CASTILLO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "678-856-5079"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "GA",
            "license": "LPC007365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.