| Mindful Mental Health Az Sun Llc | |
|
40304 W Lococo St Maricopa AZ 85138-5137 | |
| (602) 314-7225 | |
| (602) 314-7226 |
| Full Name | Mindful Mental Health Az Sun Llc |
|---|---|
| Speciality | Social Worker |
| Location | 40304 W Lococo St, Maricopa, Arizona |
| Authorized Official Name and Position | Kacie Stansfield (PRESIDENT) |
| Authorized Official Contact | 6023147225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Mental Health Az Sun Llc 40304 W Lococo St Maricopa AZ 85138-5137 Ph: (602) 314-7225 | Mindful Mental Health Az Sun Llc 40304 W Lococo St Maricopa AZ 85138-5137 Ph: (602) 314-7225 |
| NPI Number | 1770226151 |
|---|---|
| Provider Enumeration Date | 04/14/2022 |
| Last Update Date | 04/14/2022 |
| Certification Date | 04/14/2022 |
| Medicare PECOS PAC ID | 5395132120 |
|---|---|
| Medicare Enrollment ID | O20220426002887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770226151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Weise |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952723652 PECOS PAC ID: 2668451386 Enrollment ID: I20140414001095 |
| Provider Name | Melissa L Joslyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841386992 PECOS PAC ID: 4789780388 Enrollment ID: I20190307000544 |
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