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NPI Code Detail

MEDICARE: BODY AND MINDFULLY HEALTHY, LLC

MEDICARE: BODY AND MINDFULLY HEALTHY, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2261QM0850XAdult Mental Health Clinic/Center
3261QM0855XAdolescent and Children Mental Health Clinic/Center
4101YM0800XMental Health Counselor

Other Identifiers

General Provider Information

NPI Number : 1952987034
Entity Type Code : Organization
Provider Name (Legal Business Name) : BODY AND MINDFULLY HEALTHY, LLC
Provider Business Mailing Address
First Line : PO BOX 1141
Second Line :
City : GALAX
State : VA
Zip : 24333-1141
Country : US
Telephone Number : 276-601-2749
Fax Number : 540-613-1831
Provider Business Practice Location Address
First Line : 210 CALHOUN ST
Second Line :
City : GALAX
State : VA
Zip : 24333-3806
Country : US
Telephone Number : 276-293-1235
Fax Number : 540-613-1831
Authorized Official
Title or Position : CEO / FOUNDER
Name : MELISSA SUE ANN LONDRY
Credential : LPC
Telephone Number : 276-293-1235
Provider Enumeration Date : 03/20/2021
Last Update Date : 06/04/2026

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Directions to “BODY AND MINDFULLY HEALTHY, LLC ” Practice Location

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