| Mindful And Kinetic Counseling Llc | |
|
703 S Elmer Ave Ste 105 Sayre PA 18840-2400 | |
| (570) 890-9070 | |
| Not Available |
| Full Name | Mindful And Kinetic Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 703 S Elmer Ave Ste 105, Sayre, Pennsylvania |
| Authorized Official Name and Position | Karen Conklin (EXECUTIVE OFFICER) |
| Authorized Official Contact | 5704233162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful And Kinetic Counseling Llc 703 S Elmer Ave Ste 105 Sayre PA 18840-2400 Ph: (570) 890-9070 | Mindful And Kinetic Counseling Llc 703 S Elmer Ave Ste 105 Sayre PA 18840-2400 Ph: (570) 890-9070 |
| NPI Number | 1538882857 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 02/09/2024 |
| Certification Date | 11/13/2023 |
| Medicare PECOS PAC ID | 7113374380 |
|---|---|
| Medicare Enrollment ID | O20240219001216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538882857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| Provider Name | Karen Conklin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669877197 PECOS PAC ID: 4587011754 Enrollment ID: I20240219001804 |
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