Free Mind Integrated Services Llc | |
9718 Poling Ter Fort Washington MD 20744-3970 | |
(202) 677-9732 | |
(470) 705-9700 |
Full Name | Free Mind Integrated Services Llc |
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Speciality | Counselor |
Location | 9718 Poling Ter, Fort Washington, Maryland |
Authorized Official Name and Position | Stacey Michelle Rowe (OWNER) |
Authorized Official Contact | 2026779732 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Free Mind Integrated Services Llc 9718 Poling Ter Fort Washington MD 20744-3970 Ph: (202) 677-9732 | Free Mind Integrated Services Llc 9718 Poling Ter Fort Washington MD 20744-3970 Ph: (202) 677-9732 |
NPI Number | 1093432403 |
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Provider Enumeration Date | 10/26/2022 |
Last Update Date | 03/29/2023 |
Certification Date | 03/29/2023 |
Medicare PECOS PAC ID | 4688045354 |
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Medicare Enrollment ID | O20240409003070 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093432403 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Stacey Michelle Rowe |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1083213433 PECOS PAC ID: 0042681710 Enrollment ID: I20240410000074 |
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