{"npi":"1578029377","type":"NPI-2","status":"active","name":{"display":"Mind Body Counseling LLC","other":[],"organization_name":"MIND BODY COUNSELING LLC","authorised_official":"Marisa Valdiserra"},"specialty":{"primary_taxonomy":"101YP2500X","primary_taxonomy_description":"Professional Counselor","slug":"professional-counselor","schema_org_specialty":null,"all":[{"code":"101YP2500X","description":"Professional Counselor","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"100 RIVERVIEW CTR STE 240","city":"MIDDLETOWN","state":"CT","postal_code":"064573489","country_code":"US","phone":"8603732828"},{"purpose":"MAILING","street_1":"100 HUNTING HILL AVE","city":"MIDDLETOWN","state":"CT","postal_code":"064574314","country_code":"US","phone":"8603732828"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20240501003455","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CT","pac_id":"6204276637"}]},"enumeration_date":"2019-02-16","last_updated":"2025-08-20","_meta":{"source":"NPPES","snapshot_date":"2025-08-20","doc_url":"https://findmynpi.com/api"}}