Mindful One LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MINDFUL ONE LLC

Doing business as

Mindful One Therapy

Practice address

5921 Hall St
Springfield, VA 22152-1402

Phone

(571) 332-9095

NPI assigned

Jul 3, 2020

Last updated

Jul 3, 2020By 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

Dr. Mala K Tandon, PSY.DNPI 1609105188

Title

Director

Phone

(571) 332-9095

Specialties & licenses 4

Addresses

Other names 1

• Mindful One Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 3

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.

• Mala K. Tandon, PSY.D

  • Clinical Psychologist
  • Fairfax, VA
  • NPI 1609105188

  DC, Mental Health

  Medicare reassignment NPD Authorized official
• Alexis Joyner-Harris, MA

  • Mental Health Counselor
  • Fairfax, VA
  • NPI 1851186738
  NPD
• Justine Sime

  • Professional Counselor
  • Virginia Beach, VA
  • NPI 1225928419

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593734400000",
    "number": "1902423114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5921 HALL ST",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521402",
            "telephone_number": "571-332-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 HALL ST",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521402",
            "telephone_number": "571-332-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL ONE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-03",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A",
        "authorized_official_last_name": "TANDON",
        "authorized_official_first_name": "MALA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "571-332-9095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful One Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Springfield, VA
• Providers in Springfield, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.