MIND BODY SOUL - PSYCHOLOGY AND CONSULTING GROUP LLC
NPI 1912434234
Psychologist - Clinical in Ridgefield, CT

Q: What is Mind Body Soul - Psychology And Consulting Group LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since May 17, 2017

109 DANBURY ROAD, LOWER LEVEL, SUITE D6, RIDGEFIELD, CT 06877(203) 494-8468(845) 582-0764 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, May 17, 2017 (3 updates tracked since 2017).

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About Mind Body Soul - Psychology And Consulting Group Llc NPPES

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

MIND BODY SOUL - PSYCHOLOGY AND CONSULTING GROUP LLC (NPI 1912434234) is a healthcare organization registered as a clinical in Ridgefield, Connecticut and active in the NPI registry since May 2017. The organization maintains a secondary practice location in Ridgefield and lists Lori Wagner, Owner, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1912434234

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameMIND BODY SOUL - PSYCHOLOGY AND CONSULTING GROUP LLC

Location Address109 DANBURY ROAD, LOWER LEVEL, SUITE D6Ridgefield, CT 06877-0687

Mailing Address109 Danbury Road, Lower Level, Suite D6Ridgefield, CT 06877 · (203) 494-8468 · Fax (845) 582-0764

Phone(203) 494-8468

Fax(845) 582-0764

Organization SubpartNo

Authorized OfficialLori WagnerOwner, Clinical Psychologist · (203) 494-8468

Enumeration DateMay 17, 2017

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1912434234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CT · 2706

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

109 DANBURY ROAD, Ridgefield, CT 06877

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Secondary Practice Location 1

Location 1109 Danbury Rd Lowr LevelRidgefield, CT 06877-4142 · Phone (203) 494-8468 · Fax (845) 582-0764

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mind Body Soul - Psychology And Consulting Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mind Body Soul - Psychology And Consulting Group LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lori Wagner, PSY.D.

Clinical Psychologist

NPI 1285902387

109 DANBURY ROAD LOWER LEVEL, SUITE D6
Ridgefield, CT 06877

(203) 494-8468

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Soul - Psychology And Consulting Group LLC's NPI number?

The NPI number for Mind Body Soul - Psychology And Consulting Group LLC is 1912434234. It was assigned to this organization in the NPPES registry on May 17, 2017.

Where is Mind Body Soul - Psychology And Consulting Group LLC located?

Mind Body Soul - Psychology And Consulting Group LLC is located at 109 Danbury Road Lower Level, Suite D6, Ridgefield, CT 06877. The listed phone number is (203) 494-8468.

What is Mind Body Soul - Psychology And Consulting Group LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mind Body Soul - Psychology And Consulting Group LLC enrolled in Medicare?

Yes. Mind Body Soul - Psychology And Consulting Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mind Body Soul - Psychology And Consulting Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mind Body Soul - Psychology And Consulting Group LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mind Body Soul - Psychology And Consulting Group LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.