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NPI Code Detail

MEDICARE: MIND, BODY, SOULMATES

MEDICARE: MIND, BODY, SOULMATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1194479147
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND, BODY, SOULMATES
Provider Business Mailing Address
First Line : 7405 W ARIZONA PL
Second Line :
City : LAKEWOOD
State : CO
Zip : 80232-5416
Country : US
Telephone Number : 970-371-9404
Fax Number :
Provider Business Practice Location Address
First Line : 7405 W ARIZONA PL
Second Line :
City : LAKEWOOD
State : CO
Zip : 80232-5416
Country : US
Telephone Number : 970-371-9404
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. ISABLE MARIE SMITH
Credential : LCSW
Telephone Number : 970-371-9404
Provider Enumeration Date : 02/08/2022
Last Update Date : 02/08/2022

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Directions to “MIND, BODY, SOULMATES ” Practice Location

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