| Mind Body Connection | |
|
2521 E Mountain Village Dr # 661 Wasilla AK 99654-7373 | |
| (661) 336-2637 | |
| Not Available |
| Full Name | Mind Body Connection |
|---|---|
| Speciality | Social Worker |
| Location | 2521 E Mountain Village Dr # 661, Wasilla, Alaska |
| Authorized Official Name and Position | Courtney M Beebe (MENTAL HEALTH CLINICIAN) |
| Authorized Official Contact | 6613362637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Body Connection 2521 E Mountain Village Dr # 661 Wasilla AK 99654-7373 Ph: () - | Mind Body Connection 2521 E Mountain Village Dr # 661 Wasilla AK 99654-7373 Ph: (661) 336-2637 |
| NPI Number | 1366215238 |
|---|---|
| Provider Enumeration Date | 11/02/2023 |
| Last Update Date | 11/02/2023 |
| Certification Date | 11/02/2023 |
| Medicare PECOS PAC ID | 3274075999 |
|---|---|
| Medicare Enrollment ID | O20240610003656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366215238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Courtney Marie Beebe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205484045 PECOS PAC ID: 1951766211 Enrollment ID: I20230420002569 |
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