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Organization
MIND BODY WELLNESS GROUP LLC
Active
Organization
MIND BODY WELLNESS GROUP LLC
Active
Other names
Mind Body Wellness Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WALLACE STONE JR. (AUTHORIZED MANAGER)
(727) 310-5520
Entity
Organization
Contact information
Practice address
840 BEACH DR NE, ST PETERSBURG, FL 33701-2012
(727) 310-5520
Mailing address
246 22ND AVE NE, ST PETERSBURG, FL 33704-3527
(727) 310-5520
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW14906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629433636
NPI
FL
Enumeration date
08/24/2018
Last updated
09/21/2026
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