MEDICARE: MIND BODY AND SPIRIT THERAPY LLC

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1851282297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND BODY AND SPIRIT THERAPY LLC

Provider Business Mailing Address
First Line	:	1210 S GILBERT ST STE 105
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-4557
Country	:	US
Telephone Number	:	319-775-5488
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 S GILBERT ST STE 105
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-4557
Country	:	US
Telephone Number	:	319-775-5488
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADINA LEVITT
Credential	:	LISW
Telephone Number	:	319-775-5488

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

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