Mindfulness Based Interventions LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MINDFULNESS BASED INTERVENTIONS LLC

Practice address

255 Hunter Parkway
Ridgway, CO 81432

Phone

(970) 318-0529

Fax

(855) 403-3931

NPI assigned

Sep 27, 2019

Organization subpart

No

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

Authorized official

Name

Nichole L Moorman, LCSW

Title

Owner

Phone

(970) 318-0529

Specialties & licenses 1

Addresses

Other names 1

• MINDFULNESS BASED INTERVENTIONS LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mindfulness Based Interventions LLC

  • Adult Mental Health Clinic/Center
  • Delta, CO
  • NPI 1285128785

  O20180130000321

  Same enrollment
• Mindfulness Based Interventions LLC

  • Adult Mental Health Clinic/Center
  • Ridgway, CO
  • NPI 1639689938

  O20180130000321

  Same enrollment
• Mindfulness Based Interventions LLC

  • Adult Mental Health Clinic/Center
  • Ridgway, CO
  • NPI 1679067490

  O20180130000321

  Same enrollment

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1760033930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "OURAY",
            "state": "CO",
            "postal_code": "814270012",
            "telephone_number": "970-318-0529",
            "fax_number": "855-403-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HUNTER PARKWAY",
            "city": "RIDGWAY",
            "state": "CO",
            "postal_code": "81432",
            "telephone_number": "970-318-0529",
            "fax_number": "855-403-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULNESS BASED INTERVENTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "MOORMAN",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-318-0529",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINDFULNESS BASED INTERVENTIONS LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "MINDFULNESS BASED INTERVENTIONS LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Debra Ann Loberger, MT
• David Malin, PT
• Lawrence Lynch McReynolds, M.D.
• Mindfulness Based Interventions LLC
• Mindfulness Based Interventions LLC
• Mindfulness Based Interventions LLC
• Nichole L Moorman, LCSW
• Mountain Family Living, a Prof Corp
• Mountain Medical Center LLC
• Shirley L Olson, FNP

• Adult Mental Health Clinic/Center in Ridgway, CO
• Providers in Ridgway, CO by specialty
• Adult Mental Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.