The Mindful Goldfish LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE MINDFUL GOLDFISH LLC

Practice address

777 E William St Ste 108
Carson City, NV 89701-4057

Phone

(775) 400-2660

NPI assigned

Aug 15, 2025

Organization subpart

No

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

Authorized official

Name

Shannon Lee Kossick, LCSWNPI 1619639762

Title

Owner/Manager

Phone

(916) 751-9899

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shannon Lee Kossick, LCSW, LCADC

  • Clinical Social Worker
  • Carson City, NV
  • NPI 1619639762
  NPD Authorized official

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1780560482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S ROOP ST UNIT 241",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897027110",
            "telephone_number": "775-400-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E WILLIAM ST STE 108",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897014057",
            "telephone_number": "775-400-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MINDFUL GOLDFISH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "KOSSICK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "916-751-9899",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Carson City, NV
• Providers in Carson City, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.