NPIMap

Organization Active NPI

Mindful Lotus Therapy Inc

  • Clinical Social Worker
  • Davie, FL
National Provider Identifier
1871231571
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL LOTUS THERAPY INC
Practice address
6990 Griffin Rd
Davie, FL 33314-4345
Phone
(754) 248-9589
Fax
(754) 764-0054
NPI assigned
May 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Mrs. Leigh Dana Ojeda, LCSW, C-DBTNPI 1518161785
Title
Owner
Phone
(754) 248-9589

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6990 Griffin Rd
Davie, FL 33314-4345

Mailing address

6990 Griffin Rd
Davie, FL 33314-4345
Phone (754) 248-9589

Other identifiers 1

IdentifierTypeStateIssuer
114413700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220609002941 FL Part B Supplier - Clinic/Group Practice 6709264369 Receives reassigned benefits from 6 practitioners
Practice locations: Davie, FL

National Provider Directory

National Provider Directory
Tax ID family
Mindful Lotus Therapy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6824 Griffin Rd
Davie, FL 33314
Phone (754) 248-9589

6990 Griffin Rd
Davie, FL 33314
Phone (754) 248-9589

Practitioners & affiliated clinicians

Practitioners 7

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": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1871231571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6990 GRIFFIN RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144345",
            "telephone_number": "754-248-9589",
            "fax_number": "754-764-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6990 GRIFFIN RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144345",
            "telephone_number": "754-248-9589",
            "fax_number": "754-764-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LOTUS THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "OJEDA",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_middle_name": "DANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "754-248-9589",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, C-DBT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114413700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.