| Mind Over Matter Counseling, Llc | |
|
3041 W 28th Ave Pine Bluff AR 71603-4802 | |
| (870) 619-9018 | |
| Not Available |
| Full Name | Mind Over Matter Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3041 W 28th Ave, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Nikki Thornton (OWNER/LICENSED CLINICAL SOCIAL WORK) |
| Authorized Official Contact | 8706199018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Over Matter Counseling, Llc 3401 W 28th Ave Pine Bluff AR 71603 Ph: (870) 619-9018 | Mind Over Matter Counseling, Llc 3041 W 28th Ave Pine Bluff AR 71603-4802 Ph: (870) 619-9018 |
| NPI Number | 1033889001 |
|---|---|
| Provider Enumeration Date | 09/20/2021 |
| Last Update Date | 09/27/2021 |
| Certification Date | 09/27/2021 |
| Medicare PECOS PAC ID | 8123426350 |
|---|---|
| Medicare Enrollment ID | O20211001001892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033889001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nikki Thornton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215343207 PECOS PAC ID: 3072898188 Enrollment ID: I20211005002817 |
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