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MINDBODY WELLNESS, LLC
NPI 1992971675
Psychologist - Clinical in Aurora, MO

Active since May 02, 2008
1407 S ELLIOTT AVE, SUITE B, AURORA, MO 65605(417) 440-0826 Get Directions Write a Review

NPPES record last updated: May 2, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mindbody Wellness, Llc NPPES

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

MINDBODY WELLNESS, LLC (NPI 1992971675) is a healthcare organization registered as a clinical in Aurora, Missouri and active in the NPI registry since May 2008. The organization lists Stacey L. Willis-center, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1992971675
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameMINDBODY WELLNESS, LLC
Location Address1407 S ELLIOTT AVE, SUITE BAurora, MO 65605-2103
Mailing Address1407 S Elliott Ave, Suite BAurora, MO 65605-2103 · (417) 440-0826
Phone(417) 440-0826
Organization SubpartNo
Authorized OfficialStacey L. Willis-centerClinical Psychologist · (417) 440-0826
Enumeration DateMay 2, 2008
✔ NPI 1992971675 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 MO · 2008007986
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.
1407 S ELLIOTT AVE, Aurora, MO 65605
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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)

Mindbody Wellness, 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 Mindbody Wellness, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stacey Maples, PHD
Clinical Psychologist
NPI 1699947804
1407 S ELLIOTT AVE STE B
Aurora, MO 65605
(417) 440-0826
✔ 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 Mindbody Wellness, LLC's NPI number?

The NPI number for Mindbody Wellness, LLC is 1992971675. It was assigned to this organization in the NPPES registry on May 2, 2008.

Where is Mindbody Wellness, LLC located?

Mindbody Wellness, LLC is located at 1407 S Elliott Ave Suite B, Aurora, MO 65605. The listed phone number is (417) 440-0826.

What is Mindbody Wellness, LLC's specialty?

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

Is Mindbody Wellness, LLC enrolled in Medicare?

Yes. Mindbody Wellness, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mindbody Wellness, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mindbody Wellness, 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 Mindbody Wellness, LLC was last updated on May 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.