FOREVERMORE MIND BODY & SOUL NPI 1346025285

NPI Information

  • NPI: 1346025285
  • Provider Name: FOREVERMORE MIND BODY & SOUL
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • :
  • Address: 411 N BLUFF ST APT 11
    JOLIET, IL
    ZIP 60435
  • Phone: (815) 766-5999

Map and Directions

Get Directions

NPI Details

FOREVERMORE MIND BODY & SOUL is a clinic center in Joliet, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FOREVERMORE MIND BODY & SOUL NPI is 1346025285. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

411 N BLUFF ST APT 11
JOLIET, IL
ZIP 60435-295
Phone: (815) 766-5999

The provider's authorized official is Demitrius Brackett .
The authorized official title is Mental Health Provider and has the following contact phone number (815) 766-5999.

The enumeration date for this NPI number is 8/29/2023 and was last updated on 11/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC1500XClinic/CenterCommunity HealthNo
2261QP3300XClinic/CenterPainNo
3261QR1100XClinic/CenterResearchNo
4174200000XMealsNo
5251B00000XCase ManagementNo
6261QM1300XClinic/CenterMulti-SpecialtyNo
7261QV0200XClinic/CenterVANo
8261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI