Psychologist
MINDBODYMOM, INC.
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1538029988 · enumerated 2025-11-17 · record updated 2025-11-17. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Dr. SAMANTHA RUSSELL PhD, Chief Executive Officer · (970) 471-3981
Addresses and phones
- Mailing address 16192 COASTAL HWY, LEWES, DE, 19958-3608 (970) 471-3981 Google Maps Apple Maps OpenStreetMap
- Practice location 1636 W STEVANNA WAY, UNITED STATES, FLAGSTAFF, AZ, 86001 (970) 471-3981 Google Maps Apple Maps OpenStreetMap
Specialties
- Psychiatry & Neurology, Psychiatry 2084P0800X
- Psychologist 103T00000X · Primary
In this directory
Locations and evidence
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Practice location
FLAGSTAFF, AZ, 86001
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.