Mind and Body Integration, PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MIND AND BODY INTEGRATION, PLLC

Practice address

109 Latigo LN Ste G
Canon City, CO 81212-8113

Phone

(719) 430-5650

Fax

(719) 345-0607

NPI assigned

Oct 11, 2021

Last updated

Feb 21, 2023By 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

Amy R Leibli, DNP

Title

DNP, FNP-BC, Pmhnp-BC

Phone

(719) 430-5650

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1811659584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 7TH ST",
            "city": "PENROSE",
            "state": "CO",
            "postal_code": "812409312",
            "telephone_number": "719-430-5650",
            "fax_number": "719-345-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LATIGO LN STE G",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128113",
            "telephone_number": "719-430-5650",
            "fax_number": "719-345-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY INTEGRATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "LEIBLI",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DNP, FNP-BC, PMHNP-BC",
        "authorized_official_telephone_number": "719-430-5650",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Rose Miller
• Karen Lynn Miller
• Kendra Brooke Decker Miller, FNP
• Mollie T Miller
• Violet Mills
• Keith P Minihane, MD
• Emily Miozzi
• Alyssa Mitchell, LPC, LAC
• Joseph Moffitt, MDIV
• Gary Alan Mohr, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Canon City, CO
• Providers in Canon City, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.