NPIMap

Organization Active NPI

Mind Body Wellness Group LLC

  • Mental Health Counselor
  • St Petersburg, FL
National Provider Identifier
1750862017
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW14906 Issued in FL
Legal business name
MIND BODY WELLNESS GROUP LLC
Practice address
735 Arlington Ave N Ste 205
St Petersburg, FL 33701-3653
Phone
(727) 310-5520
NPI assigned
Aug 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Authorized official

Name
Mr. John Wallace Stone Jr.NPI 1629433636
Title
Authorized Manager
Phone
(727) 310-5520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X SW14906 FL Primary

Addresses

Primary practice location

735 Arlington Ave N Ste 205
St Petersburg, FL 33701-3653

Mailing address

735 Arlington Ave N Ste 205
St Petersburg, FL 33701-3653
Phone (727) 310-5520

Other practice location 1

840 Beach Dr NE
St Petersburg, FL 33701-2012
Phone (727) 310-5520

Other identifiers 1

IdentifierTypeStateIssuer
1629433636OtherFLNPI

Other names 1

  • Mind Body Wellness Group LLC Doing business as

National Provider Directory

National Provider Directory

Locations

735 Arlington Ave N
Ste 205
St Petersburg, FL 33701
Phone (727) 310-5520

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1750862017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 ARLINGTON AVE N STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013653",
            "telephone_number": "727-310-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 ARLINGTON AVE N STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013653",
            "telephone_number": "727-310-5520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Beach Dr NE",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337012012",
            "country_code": "US",
            "telephone_number": "727-310-5520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND BODY WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "AUTHORIZED MANAGER",
        "authorized_official_telephone_number": "727-310-5520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW14906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629433636",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind Body Wellness Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.