| Mary's Mind Counseling | |
|
1108 Nw 116th St Oklahoma City OK 73114-8040 | |
| (405) 551-7118 | |
| Not Available |
| Full Name | Mary's Mind Counseling |
|---|---|
| Speciality | Counselor |
| Location | 1108 Nw 116th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Mahogany Gaines (OWNER) |
| Authorized Official Contact | 4055517118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary's Mind Counseling Po Box 6311 Edmond OK 73083-6311 Ph: (405) 551-7118 | Mary's Mind Counseling 1108 Nw 116th St Oklahoma City OK 73114-8040 Ph: (405) 551-7118 |
| NPI Number | 1598544629 |
|---|---|
| Provider Enumeration Date | 09/27/2023 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Medicare PECOS PAC ID | 7810344868 |
|---|---|
| Medicare Enrollment ID | O20231113001588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598544629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Mahogany R Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629349527 PECOS PAC ID: 9638560113 Enrollment ID: I20211216001148 |
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