Mind Body and Soul Psychiatric Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4301076878 Issued in MI

Legal business name

MIND BODY AND SOUL PSYCHIATRIC SERVICES

Practice address

25882 Orchard Lake Rd
Suite L-5a
Farmington Hills, MI 48336-1292

Phone

(313) 530-3452

NPI assigned

Jan 30, 2012

Organization subpart

No

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

Authorized official

Name

Timothy Chapman, MDNPI 1023056199

Title

President/Ceo

Phone

(313) 530-3452

Specialties & licenses 1

Addresses

Tax ID family

Mind Body and Soul Psychiatric Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mind Body and Soul Psychiatric Services

  • Psychiatry Physician
  • Farmington Hills, MI
  • NPI 1841503406
  NPD tax ID

Practitioners 1

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

• Timothy L Chapman, MD

  • Psychiatry Physician
  • Farmington Hills, MI
  • NPI 1023056199
  NPD (past) Authorized official

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1821360363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23744 CORA AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362620",
            "telephone_number": "313-530-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "address_2": "SUITE L-5A",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361292",
            "telephone_number": "313-530-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY AND SOUL PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "313-530-3452",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301076878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah James Minard
• Dominique Mincey
• Mercedes Mincey, RBT
• Rayona Mincey
• Tomisha Mincey
• Mind Body and Soul Psychiatric Services
• Mind Medicine Inc
• Mind Reset Therapy
• Laura Shira Mindell, LPC
• Steven Minden

• Clinic/Center in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.