| Mind Spa Llc | |
|
7302 S Yale Ave Tulsa OK 74136-7027 | |
| (918) 591-2510 | |
| (918) 591-2511 |
| Full Name | Mind Spa Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7302 S Yale Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Sarah E Land (OWNER/MIND SPA LLC) |
| Authorized Official Contact | 9185912510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Spa Llc 7302 S Yale Ave Tulsa OK 74136-7027 Ph: (918) 591-2510 | Mind Spa Llc 7302 S Yale Ave Tulsa OK 74136-7027 Ph: (918) 591-2510 |
| NPI Number | 1891932216 |
|---|---|
| Provider Enumeration Date | 01/08/2009 |
| Last Update Date | 09/30/2022 |
| Certification Date | 09/30/2022 |
| Medicare PECOS PAC ID | 6608019120 |
|---|---|
| Medicare Enrollment ID | O20130903000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891932216 | NPI | - | NPPES |
| 200060070A | Medicaid | OK | |
| 200225500A | Medicaid | OK |
| Provider Name | Damaris G Deutsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699862573 PECOS PAC ID: 2163473208 Enrollment ID: I20050204000814 |
| Provider Name | Sarah E Land |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700956406 PECOS PAC ID: 1850317843 Enrollment ID: I20051229000717 |
| Provider Name | Kaitlin B Cores |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558518050 PECOS PAC ID: 5698949303 Enrollment ID: I20111115000458 |
| Provider Name | Kelly M Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588113831 PECOS PAC ID: 4981989993 Enrollment ID: I20170314000068 |
| Provider Name | Emily A Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730436668 PECOS PAC ID: 0840623823 Enrollment ID: I20191205000418 |
| Provider Name | Sabrina Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427229400 PECOS PAC ID: 1759713506 Enrollment ID: I20191206000606 |
| Provider Name | La Maria D Folks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962091603 PECOS PAC ID: 2769899053 Enrollment ID: I20210405000228 |
| Provider Name | Jennifer Ruth Rhine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043090103 PECOS PAC ID: 2860831146 Enrollment ID: I20240419000384 |
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