Organization Active NPI

Peaceful Mind Therapeutic Services, LLC

  • Family Health Clinical Nurse Specialist
  • Wasilla, AK
National Provider Identifier
1992404123
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
Legal business name
PEACEFUL MIND THERAPEUTIC SERVICES, LLC
Doing business as
Peaceful Mind Therapeutic Services
Practice address
1051 N Rainbow Park Dr
Wasilla, AK 99623-9241
Phone
(907) 376-3530
Fax
(907) 376-3520
NPI assigned
Feb 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Veronica R Maldonado, LCSWNPI 1285270181
Title
Owner/Clinician
Phone
(907) 376-3530

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Family Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SF0001X Primary

Addresses

Primary practice location

1051 N Rainbow Park Dr
Wasilla, AK 99623-9241

Mailing address

1051 N Rainbow Park Dr
Wasilla, AK 99623-9241
Phone (907) 376-3530

Other names 1

  • Peaceful Mind Therapeutic Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260123002555 AK Part B Supplier - Clinic/Group Practice 9436636131 Receives reassigned benefits from 1 practitioner
Practice locations: Wasilla, AK

National Provider Directory

National Provider Directory
Tax ID family
Peaceful Mind Therapeutic Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1992404123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 N RAINBOW PARK DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239241",
            "telephone_number": "907-376-3530",
            "fax_number": "907-376-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 N RAINBOW PARK DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239241",
            "telephone_number": "907-376-3530",
            "fax_number": "907-376-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL MIND THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-09-02",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "907-376-3530",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peaceful Mind Therapeutic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.