Mindful Performance Therapy, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MINDFUL PERFORMANCE THERAPY, PLLC

Practice address

1414 Trade Center Dr Ste 26-E
Traverse City, MI 49696-8944

Phone

(989) 370-0703

NPI assigned

Apr 20, 2021

Last updated

Jan 7, 2022By 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

Diana Volant, MA, LLP

Title

Owner

Phone

(989) 370-0703

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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.

• Rocky Lee Carrigan, LMCSW

  • Clinical Social Worker
  • Falmouth, MI
  • NPI 1235711656
  NPD (past)
• Devin R Frazier, PSY AIT MA

  • Psychologist
  • Livonia, MI
  • NPI 1134601628
  NPD (past)
• Azari Haygood, MA, LLP

  • Clinical Child & Adolescent Psychologist
  • Livonia, MI
  • NPI 1730531039
  NPD (past)
• Linda D Theis, L.L. P

  • Clinical Psychologist
  • Fife Lake, MI
  • NPI 1124447859
  NPD (past)

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1851972814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 TRADE CENTER DR STE 26-E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968944",
            "telephone_number": "989-370-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 TRADE CENTER DR STE 26-E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968944",
            "telephone_number": "989-370-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL PERFORMANCE THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "VOLANT",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-370-0703",
        "authorized_official_credential": "MA, LLP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Mills
• Sarah L Mills, D.O
• Ned Patrick Milne, RPH
• Alenn Dave Verzosa Mina, PHARMD
• Mindful Life Practice, LLC
• Mindset Physical Therapy LLC
• Mindspot Counseling, PLLC
• Lora Lee Minidis, LPC
• Laura Lynne Minnis, LPN
• April Ann Missias

• Clinical Psychologist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.