| Integrated Mind Psychotherapy Pllc | |
|
5705 Lynnhaven Pkwy Ste 104-1074 Virginia Beach VA 23464-9152 | |
| (757) 663-2660 | |
| Not Available |
| Full Name | Integrated Mind Psychotherapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 5705 Lynnhaven Pkwy Ste 104-1074, Virginia Beach, Virginia |
| Authorized Official Name and Position | Sara M Mccullough (OWNER) |
| Authorized Official Contact | 7576632660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Mind Psychotherapy Pllc 2005 Ramsay Ct Virginia Beach VA 23464-9000 Ph: (757) 663-2660 | Integrated Mind Psychotherapy Pllc 5705 Lynnhaven Pkwy Ste 104-1074 Virginia Beach VA 23464-9152 Ph: (757) 663-2660 |
| NPI Number | 1245959410 |
|---|---|
| Provider Enumeration Date | 08/23/2022 |
| Last Update Date | 08/23/2022 |
| Certification Date | 08/23/2022 |
| Medicare PECOS PAC ID | 8820438757 |
|---|---|
| Medicare Enrollment ID | O20240425002699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245959410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sara Michelle Mccullough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659954956 PECOS PAC ID: 2668878687 Enrollment ID: I20240425003264 |
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