Healthcare Provider Details

I. General information

NPI: 1821929613
Provider Name (Legal Business Name): MIND AND BODY HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6450 W SUNSET BLVD # 1222
HOLLYWOOD CA
90028-7315
US

IV. Provider business mailing address

6450 W SUNSET BLVD # 1222
HOLLYWOOD CA
90028-7315
US

V. Phone/Fax

Practice location:
  • Phone: 213-444-7063
  • Fax:
Mailing address:
  • Phone: 213-444-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LOREN ASHLEY MESSINA
Title or Position: OWNER
Credential: LMFT
Phone: 213-444-7063