| Mindful Journey Psychological Services Llc | |
|
4329 Charlotte St Kansas City MO 64110-1548 | |
| (816) 516-7243 | |
| Not Available |
| Full Name | Mindful Journey Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4329 Charlotte St, Kansas City, Missouri |
| Authorized Official Name and Position | Jakob James Nelson (OWNER) |
| Authorized Official Contact | 8165167243 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Journey Psychological Services Llc 4329 Charlotte St Kansas City MO 64110-1548 Ph: (816) 516-7243 | Mindful Journey Psychological Services Llc 4329 Charlotte St Kansas City MO 64110-1548 Ph: (816) 516-7243 |
| NPI Number | 1750096343 |
|---|---|
| Provider Enumeration Date | 01/18/2023 |
| Last Update Date | 01/18/2023 |
| Certification Date | 01/17/2023 |
| Medicare PECOS PAC ID | 8426420159 |
|---|---|
| Medicare Enrollment ID | O20230207000913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750096343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jakob James Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043353717 PECOS PAC ID: 1850486648 Enrollment ID: I20071009000672 |
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