| Mindful Heart Therapy, Llc | |
|
7071 S 13th St Ste 100 Oak Creek WI 53154-1466 | |
| (414) 502-8762 | |
| Not Available |
| Full Name | Mindful Heart Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7071 S 13th St Ste 100, Oak Creek, Wisconsin |
| Authorized Official Name and Position | Kelly Stewart (THERAPIST AND OWNER) |
| Authorized Official Contact | 5154808265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Heart Therapy, Llc 409 Parkway Dr South Milwaukee WI 53172-1034 Ph: () - | Mindful Heart Therapy, Llc 7071 S 13th St Ste 100 Oak Creek WI 53154-1466 Ph: (414) 502-8762 |
| NPI Number | 1063289270 |
|---|---|
| Provider Enumeration Date | 12/07/2023 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Medicare PECOS PAC ID | 5092155804 |
|---|---|
| Medicare Enrollment ID | O20240426002037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063289270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly M Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316189806 PECOS PAC ID: 0446430680 Enrollment ID: I20230801002983 |
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