BODY MIND HEALING LLC (NPI# 1578085643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578085643 |
| Entity Type | Organization |
| Organization Name | BODY MIND HEALING LLC |
| Practice Address |
1712 Osborne Rd Ste L Saint Marys GA 31558-9103 |
| Mailing Address |
602 E Bay Ave Kingsland GA 31548-5228 |
| Practice Telephone | 9126739901 |
| Mailing Telephone | 2022972825 |
| Mailing Fax Number | 9128823303 |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-07-11 |
| Authorized Official Name | RICARDO VILLALOBOS (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Telephone | 2022972825 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC008911 | GA | Behavioral Health & Social Service Providers |
| Street Address |
1712 OSBORNE RD STE L |
| City | SAINT MARYS |
| State | GA |
| Zip Code | 31558-9103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1922659192 | Christian Bianca Booker | Social Worker | 944 Kings Bay Rd. #247, St. Marys, GA 31558 | 2019-09-27 |
| 1154897296 | Shonta Harper | Counselor | 708 Osborne St Ste 104, Saint Marys, GA 31558 | 2018-10-16 |
| 1174038095 | Camden Behavioral Wellness, Inc | Counselor | 605 Osborne Street, Saint Mary's, GA 31558 | 2017-12-14 |
| 1285149427 | Urgent Care of Coastal Georgia | General Practice | 214 A Professional Circle, St. Marys, GA 31558 | 2017-12-11 |
| 1679975783 | Jeremy Cole | Behavioral Analyst | 921 Charlie Smith Sr. Highway, St. Marys, GA 31558 | 2014-09-19 |
| 1053660738 | Janice Paulino Ramirez | Nurse Practitioner | 2040 Dan Proctor Drive, Suite 170, St Marys, GA 31558 | 2012-09-10 |
| 1174899454 | Light Horse Healthcare Inc | Voluntary or Charitable | 2060 Dan Proctor Drive, Suite 3300, St Marys, GA 31558 | 2012-03-30 |
| 1316215775 | Annette O. Perry | Counselor | 4019 Hwy 40 East, St. Marys, GA 31558 | 2011-12-13 |
| 1932486271 | Sarah Jo Meyers | Speech-Language Pathologist | 2015 Osborne Rd, Unit A, St Marys, GA 31558 | 2011-11-15 |
| Find all providers in zip 31558 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760937684 | Katherine Blair | Counselor | 1201 Shadowlawn Dr Ste 119, Saint Marys, GA 31558-4074 | 2016-08-20 |
| 1508297664 | Aleta Fox | Counselor | 4499 Highway 40, Ste A, Saint Marys, GA 31558-9402 | 2013-11-27 |
| 1316383664 | Anna Christine Crafford | Counselor | 118 Sapalo Dr, Saint Marys, GA 31558-3709 | 2013-05-14 |
| 1306198809 | Neil Edwin Duchac II | Counselor | 269 Creekside Dr, Saint Marys, GA 31558-4483 | 2012-10-08 |
| 1811980519 | Molly B. Mccue | Counselor | 126 Osborne St, Saint Marys, GA 31558-8419 | 2005-08-26 |
| 1528544756 | Kimberly D Brigham | Counselor | 720 Armstrong St, Saint Marys, OH 45885-1800 | 2018-07-11 |
| 1013405299 | Jenna Beth Koesters | Counselor | 720 Armstrong St, Saint Marys, OH 45885-1800 | 2018-04-24 |
| 1538514260 | Ashley Schulze | Counselor | 720 Armstrong St, Saint Marys, OH 45885-1800 | 2016-05-02 |
| 1598160889 | Alice Williams | Counselor | 2060 Dan Proctor Dr, Suite 3300, Saint Marys, GA 31558-3894 | 2014-10-29 |
| 1952724221 | Ashley Morgan | Counselor | 2060 Dan Proctor Dr, Ste. 3300, Saint Marys, GA 31558-3894 | 2014-01-22 |
| Find all providers in SAINT MARYS | ||||
| City | SAINT MARYS |
| Zip Code | 31558 |
Please comment or provide details below to improve the information on BODY MIND HEALING LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.