| Mending Minds Mental Health Services Llc | |
|
4445 Corporation Ln Ste 264 Virginia Beach VA 23462-3671 | |
| (813) 997-2099 | |
| Not Available |
| Full Name | Mending Minds Mental Health Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4445 Corporation Ln Ste 264, Virginia Beach, Virginia |
| Authorized Official Name and Position | Brian Clukie (ADMINISTRATOR) |
| Authorized Official Contact | 8139972099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Minds Mental Health Services Llc 4445 Corporation Ln Ste 264 Virginia Beach VA 23462-3671 Ph: () - | Mending Minds Mental Health Services Llc 4445 Corporation Ln Ste 264 Virginia Beach VA 23462-3671 Ph: (813) 997-2099 |
| NPI Number | 1790569085 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Medicare PECOS PAC ID | 7517316425 |
|---|---|
| Medicare Enrollment ID | O20231218000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790569085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tracy Reid-saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336869379 PECOS PAC ID: 0143679050 Enrollment ID: I20231218000310 |
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