NPIMap

Organization Active NPI

LB Mindful Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Petersburg, FL
National Provider Identifier
1861131583
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LB MINDFUL WELLNESS LLC
Practice address
7901 4TH St N Ste 300
Saint Petersburg, FL 33702-4399
Phone
(561) 493-3212
NPI assigned
Jun 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Lyssa Brooks, PMHNPNPI 1184243628
Title
Sole-Member
Phone
(954) 600-2756

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary
Primary Care Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

7901 4TH St N Ste 300
Saint Petersburg, FL 33702-4399

Mailing address

980 N Federal Hwy Ste 110
Boca Raton, FL 33432-2704
Phone (303) 285-1117

Other practice location 1

1942 Broadway Ste 314C
Boulder, CO 80302-5233
Phone (303) 459-7752

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1861131583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 N FEDERAL HWY STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334322704",
            "telephone_number": "303-285-1117",
            "fax_number": "720-562-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "561-493-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1942 Broadway Ste 314C",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803025233",
            "country_code": "US",
            "telephone_number": "303-459-7752",
            "fax_number": "727-800-2333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LB MINDFUL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "LYSSA",
        "authorized_official_title_or_position": "SOLE-MEMBER",
        "authorized_official_telephone_number": "954-600-2756",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.