| Mind Matter Llc | |
|
307 S Front St Ste 115 Marquette MI 49855-4610 | |
| (906) 273-2507 | |
| (906) 273-2507 |
| Full Name | Mind Matter Llc |
|---|---|
| Speciality | Social Worker |
| Location | 307 S Front St Ste 115, Marquette, Michigan |
| Authorized Official Name and Position | Mindy Sue Miller (OWNER) |
| Authorized Official Contact | 9062732507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Matter Llc 307 S Front St Ste 115 Marquette MI 49855-4610 Ph: (906) 273-2507 | Mind Matter Llc 307 S Front St Ste 115 Marquette MI 49855-4610 Ph: (906) 273-2507 |
| NPI Number | 1386115814 |
|---|---|
| Provider Enumeration Date | 12/10/2018 |
| Last Update Date | 10/23/2022 |
| Certification Date | 10/23/2022 |
| Medicare PECOS PAC ID | 5597090050 |
|---|---|
| Medicare Enrollment ID | O20190706000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386115814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mindy S Flanigan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508849159 PECOS PAC ID: 8729269782 Enrollment ID: I20110223000860 |
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