| Mind Over Matter Therapeutic Services Llc | |
|
212 W 7th St Unit 102 Richmond VA 23224-2357 | |
| (917) 736-7538 | |
| Not Available |
| Full Name | Mind Over Matter Therapeutic Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 212 W 7th St Unit 102, Richmond, Virginia |
| Authorized Official Name and Position | Krystal Cromwell (CEO) |
| Authorized Official Contact | 9177367538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Over Matter Therapeutic Services Llc 212 W 7th St Unit 102 Richmond VA 23224-2357 Ph: (917) 736-7538 | Mind Over Matter Therapeutic Services Llc 212 W 7th St Unit 102 Richmond VA 23224-2357 Ph: (917) 736-7538 |
| NPI Number | 1851037774 |
|---|---|
| Provider Enumeration Date | 05/12/2022 |
| Last Update Date | 05/12/2022 |
| Certification Date | 05/12/2022 |
| Medicare PECOS PAC ID | 0840733903 |
|---|---|
| Medicare Enrollment ID | O20240617003290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851037774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Krystal Ma Cromwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265101257 PECOS PAC ID: 8527501691 Enrollment ID: I20240617003587 |
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