| Enlightened Mind Counseling Llc | |
|
150 S Pine Island Rd Plantation FL 33324-2669 | |
| (954) 228-0856 | |
| (855) 794-0961 |
| Full Name | Enlightened Mind Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 150 S Pine Island Rd, Plantation, Florida |
| Authorized Official Name and Position | Amanda Gurgel (CEO) |
| Authorized Official Contact | 9542280856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enlightened Mind Counseling Llc 1440 N Park Dr Weston FL 33326-3207 Ph: (954) 228-0856 | Enlightened Mind Counseling Llc 150 S Pine Island Rd Plantation FL 33324-2669 Ph: (954) 228-0856 |
| NPI Number | 1831862523 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 12/28/2022 |
| Certification Date | 12/28/2022 |
| Medicare PECOS PAC ID | 7416328158 |
|---|---|
| Medicare Enrollment ID | O20230117002539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831862523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jaelah Enoc Mendez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952889974 PECOS PAC ID: 4880932540 Enrollment ID: I20190205003127 |
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