# MIND, BODY AND SOUL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891097630
- **Authorized official:** MELISSA KELLY LMFT (OWNER)
- **Authorized official phone:** (860) 716-6246

## Contact information

- **Practice address:** 21 NEW BRITAIN AVE, SUITE 215, ROCKY HILL, CT 06067-1100
- **Practice address phone:** (860) 716-6246
- **Mailing address:** 21 NEW BRITAIN AVE, SUITE 215, ROCKY HILL, CT 06067-1100
- **Mailing address phone:** (860) 716-6246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 001163 | CT | Yes |

## Other

- **Enumeration date:** 11/30/2010
- **Last updated:** 11/30/2010