NPIMap

Organization Active NPI

Wellness Mindset Counseling Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Cloud, FL
National Provider Identifier
1992573166
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WELLNESS MINDSET COUNSELING SERVICES LLC
Doing business as
Wellness Mindset Counseling Services LLC
Practice address
1417 Hamlin Ave Unit G
Saint Cloud, FL 34771-8590
Phone
(407) 676-4276
NPI assigned
Dec 18, 2023
Last updated
Apr 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Authorized official

Name
Ekiba Ayisha SmithNPI 1902043797
Title
Owner
Phone
(407) 676-4276

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

1417 Hamlin Ave Unit G
Saint Cloud, FL 34771-8590

Mailing address

1427 Belladonna PL # 1018
Saint Cloud, FL 34771-5813
Phone (954) 465-4942

Other names 1

  • Wellness Mindset Counseling Services LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241003000266 FL Part B Supplier - Clinic/Group Practice 6406387331 Receives reassigned benefits from 7 practitioners
Practice locations: Saint Cloud, FL

National Provider Directory

National Provider Directory

Locations

1417 Hamlin Ave
Unit G
Saint Cloud, FL 34771
Phone (407) 673-4276

1427 Belladonna Pl
Saint Cloud, FL 34771
Phone (201) 245-6941

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1992573166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 BELLADONNA PL # 1018",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347715813",
            "telephone_number": "954-465-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 HAMLIN AVE UNIT G",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347718590",
            "telephone_number": "407-676-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS MINDSET COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EKIBA",
        "authorized_official_middle_name": "AYISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-676-4276"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Mindset Counseling Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.