Mind Body Wellness Group LLC
Counselor, Mental Health in St Petersburg, FL. Organization (NPI-2).
NPI number1750862017
StatusActive
Last updated in NPPESOct 1, 2026
Details
- NPI
- 1750862017
- Entity type
- Organization (NPI-2)
- Legal business name
- Mind Body Wellness Group LLC
- Organization subpart
- No
- Enumeration date
- Aug 24, 2018
- Certification date
- Oct 1, 2026
- Last updated
- Oct 1, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | SW14906 | FL | Yes |
Other names
- Mind Body Wellness Group LLC (Doing Business As)
Practice location
7901 4th St N Ste 307St Petersburg, FL 33702-4313
Phone 727-310-5520
Mailing address
246 22nd Ave NeSt Petersburg, FL 33704-3527
Phone 727-310-5520
Authorized official
John Wallace Stone
Authorized Manager
7273105520
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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