Mindfulness Renewed LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFULNESS RENEWED LLC

Practice address

107G Fenn Rd
Newington, CT 06111-2250

Phone

(860) 580-9883

NPI assigned

Apr 8, 2024

Organization subpart

No

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

Authorized official

Name

Carly Sundel, LCSWNPI 1669872743

Title

Founder/Owner

Phone

(860) 580-9883

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carly Sundel, LCSW

  • Clinical Social Worker
  • Wethersfield, CT
  • NPI 1669872743
  Medicare reassignment NPD Authorized official
• Patrick Ciardullo, LPCA

  • Professional Counselor
  • Newington, CT
  • NPI 1891640389
  NPD (past)
• Zuleyka Morales Shaw, LMFTA

  • Marriage & Family Therapist
  • Newington, CT
  • NPI 1427790161
  NPD (past)

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1821841206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 FENN RD STE G",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112250",
            "telephone_number": "860-580-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107G FENN RD",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112250",
            "telephone_number": "860-580-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULNESS RENEWED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "SUNDEL",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "FOUNDER/OWNER",
        "authorized_official_telephone_number": "860-580-9883",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Mesick Meth, A.P.R.N.
• Charleen K Miele, LPC
• Jeffrey J Mihalek, M.D.
• Maurice Randolph Miles, PSY.D.
• Stephen J Milewski, MD
• Francis Mir, DDS
• Roxana Mir, MD, MPH
• Jennifer J Mitchell
• Jennifer Elizabeth Mitton, LCSW
• Laila O Mnayer, M.S, PH.D.

• Clinical Social Worker in Newington, CT
• Providers in Newington, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.