Mind and Body Balance

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MIND AND BODY BALANCE

Practice address

507 Lacey CT
Tooele, UT 84074-4119

Phone

(435) 843-1348

NPI assigned

Jan 27, 2022

Organization subpart

No

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

Authorized official

Name

Alvilda Olivia Pacheco, CMHCNPI 1881238608

Title

Therapist

Phone

(435) 843-1348

Specialties & licenses 1

Addresses

Other names 1

• Life Balance Therapy Doing business as

Practitioners 1

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

• Alvilda Olivia Pacheco

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1881238608
  NPD Authorized official

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1932852225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 LACEY CT",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840744119",
            "telephone_number": "435-843-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 LACEY CT",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840744119",
            "telephone_number": "435-843-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY BALANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "ALVILDA",
        "authorized_official_middle_name": "OLIVIA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "435-843-1348",
        "authorized_official_credential": "CMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Balance Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Jason Miles, BHCM
• Cass Carrol Miller
• Juli Miller, CSW
• Alda G Mills-Marques, CPM
• Courtney Milner
• Mir-Mustafa Mir-Kasimov, MD
• Mira Counseling Services, LLC
• MKG Enterprises
• Lydia Baby Mmola, CSW
• Monique Mondragon

• Mental Health Clinic/Center (Including Community Mental Health Center) in Tooele, UT
• Providers in Tooele, UT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.