Mind Flex LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS01634 Issued in PA

Legal business name

MIND FLEX LLC

Practice address

254 Radcliffe St
3Rd Floor
Bristol, PA 19007-5014

Phone

(610) 812-4730

NPI assigned

Nov 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Lee Anthony Picariello, PSY.D

Title

Executive Director/Psychologist

Phone

(610) 812-4571

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1881921500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 RADCLIFFE ST",
            "address_2": "3RD FLOOR",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190075014",
            "telephone_number": "610-812-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 RADCLIFFE ST",
            "address_2": "3RD FLOOR",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190075014",
            "telephone_number": "610-812-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND FLEX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "PICARIELLO",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/PSYCHOLOGIST",
        "authorized_official_telephone_number": "610-812-4571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS01634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Bristol, PA
• Providers in Bristol, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.