| Good Mind Pllc | |
|
15324 E Jefferson Ave Ste 2 Grosse Pointe Park MI 48230-1378 | |
| (586) 899-0814 | |
| Not Available |
| Full Name | Good Mind Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15324 E Jefferson Ave Ste 2, Grosse Pointe Park, Michigan |
| Authorized Official Name and Position | Yolanda Dobbyn (OFFICE MANAGER) |
| Authorized Official Contact | 5868990814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Mind Pllc 15324 E Jefferson Ave Ste 2 Grosse Pointe Park MI 48230-1378 Ph: (586) 899-0814 | Good Mind Pllc 15324 E Jefferson Ave Ste 2 Grosse Pointe Park MI 48230-1378 Ph: (586) 899-0814 |
| NPI Number | 1184214942 |
|---|---|
| Provider Enumeration Date | 01/25/2021 |
| Last Update Date | 08/01/2022 |
| Certification Date | 08/01/2022 |
| Medicare PECOS PAC ID | 9830570605 |
|---|---|
| Medicare Enrollment ID | O20220726000647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184214942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Alicja Dorota Wasilewski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821057159 PECOS PAC ID: 8628054087 Enrollment ID: I20040625001037 |
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