| Mantra Mental Health, Llc | |
|
4041 N High St Ste 300h Columbus OH 43214-3200 | |
| (614) 984-4394 | |
| Not Available |
| Full Name | Mantra Mental Health, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4041 N High St Ste 300h, Columbus, Ohio |
| Authorized Official Name and Position | Samantha Bergstein (CEO) |
| Authorized Official Contact | 7407074488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mantra Mental Health, Llc 4041 N High St Ste 300h Columbus OH 43214-3200 Ph: (614) 984-4394 | Mantra Mental Health, Llc 4041 N High St Ste 300h Columbus OH 43214-3200 Ph: (614) 984-4394 |
| NPI Number | 1285266445 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 12/21/2023 |
| Certification Date | 12/21/2023 |
| Medicare PECOS PAC ID | 3971922543 |
|---|---|
| Medicare Enrollment ID | O20200930003325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285266445 | NPI | - | NPPES |
| 0413879 | Medicaid | OH | |
| 1473276 | Medicaid | OH | |
| 0472290 | Medicaid | OH | |
| 0264054 | Medicaid | OH | |
| 0268947 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Victoria Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073016390 PECOS PAC ID: 7012261076 Enrollment ID: I20181112001081 |
| Provider Name | Samantha Lee Bergstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417463183 PECOS PAC ID: 3375978216 Enrollment ID: I20200122002545 |
| Provider Name | Alison Leigh Mcgucken |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235896168 PECOS PAC ID: 0143614743 Enrollment ID: I20220224001934 |
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