Active NPI
Mindful Behavioral Healthcare, LLC
- Community/Behavioral Health Agency
- Kissimmee, FL
National Provider Identifier
1760152938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- MINDFUL BEHAVIORAL HEALTHCARE, LLC
- Practice address
- 711 E Oak St
Kissimmee, FL 34744-4573 - Phone
- (407) 846-0533
- Fax
- (407) 518-1730
- NPI assigned
- Sep 17, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle A Missigman
- Title
- Coo
- Phone
- (352) 328-9139
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
711 E Oak St
Kissimmee, FL 34744-4573
Mailing address
717 E Oak St
Kissimmee, FL 34744-4580
Phone (407) 846-0533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019725403 | Medicaid | FL |
National Provider Directory
National Provider Directory- Tax ID family
- Mindful Behavioral Healthcare LLC
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatry Physician
- Orlando, FL
- NPI 1447920616
-
- Psychiatry Physician
- Kissimmee, FL
- NPI 1548932866
-
- Psychiatry Physician
- Kissimmee, FL
- NPI 1578235826
-
- Community/Behavioral Health Agency
- Orlando, FL
- NPI 1679243836
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Kissimmee, FL
- NPI 1144322025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1643155200000",
"number": "1760152938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 E OAK ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347444580",
"telephone_number": "407-846-0533",
"fax_number": "407-518-1730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 E OAK ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347444573",
"telephone_number": "407-846-0533",
"fax_number": "407-518-1730"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINDFUL BEHAVIORAL HEALTHCARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-17",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A",
"authorized_official_last_name": "MISSIGMAN",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "352-328-9139"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019725403",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.