Mindful Mentality, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MINDFUL MENTALITY, LLC

Practice address

3633 Wheeler Rd Ste 320
Augusta, GA 30909-6552

Phone

(068) 423-2797

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Anne Northington-Reissman, PHD, QBA

Title

Owner and Psychologist

Phone

(630) 926-0577

Specialties & licenses 5

Addresses

Other identifiers 4

Practitioners 1

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

• Stephanie Anne Northington, PH.D.

  • Psychologist
  • Augusta, GA
  • NPI 1457632150

  Behavior Analyst

  NPD

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1871210260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 STONE MEADOWS CT",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135943",
            "telephone_number": "630-926-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 WHEELER RD STE 320",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096552",
            "telephone_number": "068-423-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MENTALITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "NORTHINGTON-REISSMAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER AND PSYCHOLOGIST",
        "authorized_official_telephone_number": "630-926-0577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, QBA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346811775",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457632150",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "15488319602",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528639952",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daphne J. Milner, RN
• Benjamin Walton Mims, DO
• Rebecca Mims, NP
• Tanya Lynn Mims, FNP-BC
• Abby Elizabeth Mincey
• Priyanka Minhas, MD
• Nora D Mintz, CRNA
• Michael Lee Minyard, D.M.D, M.P.H.
• Miracle Making Ministries, Inc.
• Dwight Paul Mirmow, M.D.

• Mental Health Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.