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MIND BODY ENDURANCE LLC
NPI 1053018903
Psychologist - Exercise & Sports in Saint Louis, MO

Active since February 10, 2023
16 N GORE AVE STE 204, SAINT LOUIS, MO 63119(513) 505-2160 Get Directions Write a Review

NPPES record last updated: February 10, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mind Body Endurance Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIND BODY ENDURANCE LLC (NPI 1053018903) is a healthcare organization registered as an exercise & sports in Saint Louis, Missouri and active in the NPI registry since February 2023. The organization lists Riley Nickols, Owner, as its authorized official.

NPPES Registry Identity

NPI1053018903
Entity TypeOrganization
Primary Taxonomy103TE1100X
Legal Business NameMIND BODY ENDURANCE LLC
Location Address16 N GORE AVE STE 204Saint Louis, MO 63119-2315
Mailing Address16 N Gore Ave Ste 204Saint Louis, MO 63119-2315 · (513) 505-2160
Phone(513) 505-2160
Organization SubpartNo
Authorized OfficialRiley NickolsOwner · (513) 505-2160
Enumeration DateFebruary 10, 2023
NPPES CertifiedFebruary 10, 2023
✔ NPI 1053018903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Exercise & SportsBehavioral Health & Social Service Providers
Taxonomy Code103TE1100X
Definition
A psychologist with a proficiency in sports psychology that uses psychological knowledge and skills to address optimal performance and well-being of athletes, developmental and social aspects of sports participation, and systemic issues associated with sports settings and organizations. APA recognizes sport psychology as a proficiency acquired after a doctoral degree in one of the primary areas of psychology and licensure as a psychologist. This proficiency does not include those who have earned a doctoral degree in sport psychology but are not licensed psychologists.
16 N GORE AVE STE 204, Saint Louis, MO 63119
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Other Names 1

Doing Business AsMind Body Endurance Llc

Other Identifiers 1

Medicaid1790019511MO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mind Body Endurance LLC's NPI number?

The NPI number for Mind Body Endurance LLC is 1053018903. It was assigned to this organization in the NPPES registry on February 10, 2023.

Where is Mind Body Endurance LLC located?

Mind Body Endurance LLC is located at 16 N Gore Ave Ste 204, Saint Louis, MO 63119. The listed phone number is (513) 505-2160.

What is Mind Body Endurance LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Exercise & Sports, with taxonomy code 103TE1100X.

When was this NPI record last updated?

The NPPES record for Mind Body Endurance LLC was last updated on February 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.