Mind and Body Wellness Services LLC

Primary specialty

PsychoanalystTaxonomy code 102L00000X

Legal business name

MIND AND BODY WELLNESS SERVICES LLC

Practice address

302 5TH Ave Ste 804
New York, NY 10001-3604

Phone

(347) 453-1601

NPI assigned

Feb 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Edgard Francisco Danielsen, LPNPI 1033578778

Title

Ceo

Phone

(347) 453-1601

Specialties & licenses 5

Addresses

Locations

Practitioners 2

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

• Edgard Danielsen, L.P.

  • Psychoanalyst
  • New York, NY
  • NPI 1033578778
  NPD Authorized official
• William Moran-Berberena, LMSW

  • Social Worker
  • New York, NY
  • NPI 1184238529
  NPD

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

{
    "created_epoch": "1582329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1902430556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 GENOVESE LN",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070657002",
            "telephone_number": "347-453-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 5TH AVE STE 804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013604",
            "telephone_number": "347-453-1601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 Genovese Ln",
            "address_purpose": "LOCATION",
            "city": "Rahway",
            "state": "NJ",
            "postal_code": "070657002",
            "country_code": "US",
            "telephone_number": "347-453-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND AND BODY WELLNESS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-22",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "DANIELSEN",
        "authorized_official_first_name": "EDGARD",
        "authorized_official_middle_name": "FRANCISCO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-453-1601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Safari Mincey
• Caryn Adele Minchella, LCSW-R
• Lauren Ashley Minchen, RD, CDN
• Gianna Marelle Mincone
• Mind and Body Occupational Therapy, P.C.
• Mind Base Psychotherapy LCSW PLLC
• Mind Body Medical Services, P.C. of Co
• Mind Body Medical Services, P.C., of NJ
• Mind Body Medical Services, PC
• Mind Bridge Health NP in Psychiatry

• Psychoanalyst in New York, NY
• Providers in New York, NY by specialty
• Psychoanalyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.