Mind, Body & Spirit Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MIND, BODY & SPIRIT COUNSELING LLC

Practice address

2180 E 4500 S Ste 125
Salt Lake City, UT 84117-4021

Phone

(801) 520-3490

NPI assigned

Apr 29, 2017

Last updated

May 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lorri K Lake, CMHC

Title

Owner

Phone

(801) 520-3490

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1811422611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 E 4500 S STE 125",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174021",
            "telephone_number": "801-520-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 E 4500 S STE 125",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174021",
            "telephone_number": "801-520-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND, BODY & SPIRIT COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-29",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "LORRI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-520-3490",
        "authorized_official_credential": "CMHC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Camille Michael Minder, M.D.
• Mindful Healing LLC (Southwick Integrative Healing)
• Mindful Infusions

• Mental Health Counselor in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.