Provider Type Icon

MINDFULLY WHOLE PSYCHOTHERAPY LLC NPI 1689111379


NPI Information

NPI: 1689111379
Provider Name: MINDFULLY WHOLE PSYCHOTHERAPY LLC
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
4057 W ILDEREEN ST
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 413-4991
Get Directions

MINDFULLY WHOLE PSYCHOTHERAPY LLC is an adolescent and children mental health clinic center in Springfield, MO. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. MINDFULLY WHOLE PSYCHOTHERAPY LLC NPI is 1689111379. The provider is registered as an organization entity type.

The provider's business location address is:

4057 W ILDEREEN ST
SPRINGFIELD, MO
ZIP 65807-063
Phone: (417) 413-4991
Fax: (417) 719-7995

The provider's authorized official is Barbara Manzer Farrell .
The authorized official title is Owner and has the following contact phone number (417) 413-4991.

The enumeration date for this NPI number is 1/19/2017 and was last updated on 2/13/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0850XClinic/CenterAdult Mental Health2016005653MISSOURINo
2261QM0855XClinic/CenterAdolescent and Children Mental Health2016005653MISSOURIYes

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: 4/28/2024

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.