Mindful Peace Trauma Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5705 Issued in OK

Legal business name

MINDFUL PEACE TRAUMA THERAPY LLC

Practice address

8703 W 151St St S
Sapulpa, OK 74066-1043

Phone

(316) 305-6064

NPI assigned

Mar 12, 2018

Organization subpart

No

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

Authorized official

Name

Brenda Jean McEntire Uphold, LCSWNPI 1760815187

Title

Owner/Therapist

Phone

(316) 305-6064

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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

• Brenda McEntire Uphold, LCSW

  • Clinical Social Worker
  • Sapulpa, OK
  • NPI 1760815187
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1831692367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 W 151ST ST S",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740661043",
            "telephone_number": "316-305-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8703 W 151ST ST S",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740661043",
            "telephone_number": "316-305-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL PEACE TRAUMA THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "MCENTIRE UPHOLD",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "316-305-6064",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "5705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.