NPIMap

Organization Active NPI

Mindful Moments LLC

  • Adult Mental Health Clinic/Center
  • Detroit, MI
National Provider Identifier
1962842005
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MINDFUL MOMENTS LLC
Practice address
5737 Harvard Rd
Detroit, MI 48224-2007
Phone
(888) 508-0903
NPI assigned
Jul 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Authorized official

Name
Dr. Latisha Braboy, PSY.D,LLP.LMSW,ACSWNPI 1538310305
Title
Sole Proprietor
Phone
(888) 508-0903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

5737 Harvard Rd
Detroit, MI 48224-2007

Mailing address

5737 Harvard Rd
Detroit, MI 48224-2007

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1962842005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5737 HARVARD RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482242007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5737 HARVARD RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482242007",
            "telephone_number": "888-508-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MOMENTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "BRABOY",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "888-508-0903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D,LLP.LMSW,ACSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.