Mietus NP Mental Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MIETUS NP MENTAL HEALTH, LLC

Doing business as

Mental Wellbeing NP

Practice address

428 Minnesota St Ste 500
Saint Paul, MN 55101-2666

Phone

(612) 662-9604

Fax

(612) 474-9072

NPI assigned

Feb 12, 2019

Last updated

Jul 31, 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

Stacey Thompson Mietus, APRN, CNPNPI 1447667456

Title

Self-Employed Nurse Practitioner

Phone

(612) 226-2912

Specialties & licenses 1

Addresses

Other names 1

• Mental Wellbeing NP Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

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, and the practitioner matching its NPPES authorized official.

• Stacey Thompson Mietus, APRN, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
  • NPI 1447667456
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1851857106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 MINNESOTA ST STE 500",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012666",
            "telephone_number": "612-662-9604",
            "fax_number": "612-474-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIETUS NP MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "MIETUS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "THOMPSON",
        "authorized_official_title_or_position": "SELF-EMPLOYED NURSE PRACTITIONER",
        "authorized_official_telephone_number": "612-226-2912",
        "authorized_official_credential": "APRN, CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Wellbeing NP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.