| Mindful Expressions Counseling Pllc | |
|
8128 River Rd Se Southport NC 28461-8972 | |
| (910) 367-5036 | |
| (910) 477-9030 |
| Full Name | Mindful Expressions Counseling Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8128 River Rd Se, Southport, North Carolina |
| Authorized Official Name and Position | Shannon A Perez (THERAPIST/OWNER) |
| Authorized Official Contact | 9103675036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Expressions Counseling Pllc 5503 Rob Gandy Blvd Suite 1d Southport NC 28461 Ph: () - | Mindful Expressions Counseling Pllc 8128 River Rd Se Southport NC 28461-8972 Ph: (910) 367-5036 |
| NPI Number | 1134894850 |
|---|---|
| Provider Enumeration Date | 08/13/2021 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 5698163103 |
|---|---|
| Medicare Enrollment ID | O20211102000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134894850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Shannon A Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083232631 PECOS PAC ID: 6507254018 Enrollment ID: I20211102000812 |
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