Mind Body Wellness LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

42214 Issued in AZ

Legal business name

MIND BODY WELLNESS LLC

Practice address

1753 E Broadway Rd Ste 101-460
Tempe, AZ 85282-2081

Phone

(480) 345-5420

NPI assigned

Nov 4, 2014

Organization subpart

No

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

Authorized official

Name

Bahar Golestan, MD

Title

Provider

Phone

(480) 345-5420

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1912302845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 E BROADWAY RD STE 101-460",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 E BROADWAY RD STE 101-460",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822081",
            "telephone_number": "480-345-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "GOLESTAN",
        "authorized_official_first_name": "BAHAR",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "480-345-5420",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "42214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace Martin Miller, M.S.
• Christopher Royce Milligan, NMD
• Cailin Mills, LAMFT
• Eva T Minaskeian, ASSOCIATE LMFT
• Mind & Body Neurology, LLC
• Mind-Full Music Therapy Services
• Mind-Touch Psychiatry & Integrative Care, LLC
• Mindful Counseling and Supervision PLLC
• Mindful Minds Counseling LLC
• Mindwell LLC

• Psychiatry Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.