Mindwell Counseling Group | |
1750 Kilbourn St Elkhart IN 46514-1920 | |
(574) 266-8066 | |
Not Available |
Full Name | Mindwell Counseling Group |
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Speciality | Counselor |
Location | 1750 Kilbourn St, Elkhart, Indiana |
Authorized Official Name and Position | Michelle Thomas (MANAGER) |
Authorized Official Contact | 5748668066 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mindwell Counseling Group 1750 Kilbourn St Elkhart IN 46514-1920 Ph: (574) 266-8066 | Mindwell Counseling Group 1750 Kilbourn St Elkhart IN 46514-1920 Ph: (574) 266-8066 |
NPI Number | 1184245466 |
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Provider Enumeration Date | 04/28/2020 |
Last Update Date | 09/20/2021 |
Certification Date | 09/20/2021 |
Medicare PECOS PAC ID | 8426474149 |
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Medicare Enrollment ID | O20200812001798 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184245466 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Kathleen R Mast |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1275501355 PECOS PAC ID: 8022074921 Enrollment ID: I20041202000554 |
Provider Name | Michelle R Thomas |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1801041488 PECOS PAC ID: 2668664764 Enrollment ID: I20101007000829 |
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