| Mind & Soul Counseling Services Llc | |
|
1845 S Dobson Rd Ste 101 Mesa AZ 85202-5662 | |
| (480) 229-6053 | |
| Not Available |
| Full Name | Mind & Soul Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 1845 S Dobson Rd Ste 101, Mesa, Arizona |
| Authorized Official Name and Position | Churice Westbrook (OWNER) |
| Authorized Official Contact | 4802296053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind & Soul Counseling Services Llc 1845 S Dobson Rd Ste 101 Mesa AZ 85202-5662 Ph: (480) 229-6053 | Mind & Soul Counseling Services Llc 1845 S Dobson Rd Ste 101 Mesa AZ 85202-5662 Ph: (480) 229-6053 |
| NPI Number | 1962095927 |
|---|---|
| Provider Enumeration Date | 02/19/2021 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 4486094083 |
|---|---|
| Medicare Enrollment ID | O20240430001889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962095927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Churice Westbrook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114486594 PECOS PAC ID: 6204276801 Enrollment ID: I20240430002069 |
| Provider Name | Katie Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518730233 PECOS PAC ID: 9537509161 Enrollment ID: I20240430003395 |
| Provider Name | Mark D Mansfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952879520 PECOS PAC ID: 7113362542 Enrollment ID: I20240508002481 |
| Provider Name | Patricia Danna-premo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992360713 PECOS PAC ID: 6608211040 Enrollment ID: I20240510003368 |
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