{
"Npi": {
"NPI": "1265398127",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MINDFUL MENTAL HEALTH PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5602 SEMINOLE VALLEY TRL NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CEDAR RAPIDS",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "52411-7891",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "319-270-0892",
"MailingAddressFaxNumber": "319-270-0892",
"FirstLinePracticeLocationAddress": "221 E COLLEGE ST STE 211",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "IOWA CITY",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "52240-1759",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "319-337-3313",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/05/2026",
"LastUpdateDate": "01/05/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLARK",
"AuthorizedOfficialFirstName": "NATASHA",
"AuthorizedOfficialMiddleName": "LEIGH",
"AuthorizedOfficialTitle": "PMHNP",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ARNP",
"AuthorizedOfficialTelephoneNumber": "319-337-3313",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}