MIND BODY AND SOUL LLC
NPI 1508325366
Counselor - Professional in Las Vegas, NV

Active since March 19, 2019
1405 SAN JUAN HILLS DR UNIT 105, LAS VEGAS, NV 89134(770) 341-4402 Get Directions Write a Review

NPPES record last updated: March 19, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Counselor
  • Professional

About MIND BODY AND SOUL LLC

This page provides the complete NPI Profile along with additional information for Mind Body And Soul Llc, a provider established in Las Vegas, Nevada operating as a Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1508325366 assigned on March 2019. The practitioner's primary taxonomy code is 101YP2500X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Mind Body And Soul Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Jeffrey Carson (Ceo)

NPI
1508325366 Verify this NPI
Provider Name
MIND BODY AND SOUL LLC
Entity Type
Organization
Location Address
1405 SAN JUAN HILLS DR UNIT 105 LAS VEGAS, NV 89134
Location Phone
(770) 341-4402
Mailing Address
1405 SAN JUAN HILLS DR UNIT 105 LAS VEGAS, NV 89134
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-19-2019
Last Update Date
03-19-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101YA0400XBehavioral Health & Social Service Providers

Counselor
Addiction (Substance Use Disorder)

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JEFFREY CARSON

Authorized Official Title
CEO
Authorized Official Phone
(770) 364-4402

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
NV20191215058OTHER (01)NVBUSINESS LICENSE

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Counselor (Addiction (Substance Use Disorder))
1405 SAN JUAN HILLS DR UNIT 105
LAS VEGAS, NV 89134

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508325366, enumerated as an "organization" on March 19, 2019.

The provider is located at 1405 SAN JUAN HILLS DR UNIT 105 LAS VEGAS, NV 89134 and the phone number is (770) 341-4402.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.