| Mindful Mental Health Network Llc | |
|
19549 N Coquina Way Weston FL 33332-2418 | |
| (754) 778-7887 | |
| Not Available |
| Full Name | Mindful Mental Health Network Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19549 N Coquina Way, Weston, Florida |
| Authorized Official Name and Position | Angelina Velichko (OWNER) |
| Authorized Official Contact | 7547787887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Mental Health Network Llc 19549 N Coquina Way Weston FL 33332-2418 Ph: (754) 778-7887 | Mindful Mental Health Network Llc 19549 N Coquina Way Weston FL 33332-2418 Ph: (754) 778-7887 |
| NPI Number | 1417631136 |
|---|---|
| Provider Enumeration Date | 06/13/2023 |
| Last Update Date | 06/13/2023 |
| Certification Date | 06/13/2023 |
| Medicare PECOS PAC ID | 3870954001 |
|---|---|
| Medicare Enrollment ID | O20230803001692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417631136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Debra Dean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932118841 PECOS PAC ID: 2668370586 Enrollment ID: I20160630000887 |
| Provider Name | Katrina Forman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447538269 PECOS PAC ID: 1658785233 Enrollment ID: I20210121001896 |
| Provider Name | Sheryl Ann Lerner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508418187 PECOS PAC ID: 8820994114 Enrollment ID: I20210719001510 |
| Provider Name | Steven G Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023267382 PECOS PAC ID: 4981646171 Enrollment ID: I20230421000949 |
| Provider Name | Camille Burke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184176661 PECOS PAC ID: 4789048646 Enrollment ID: I20230911002011 |
| Provider Name | Tristan Freedman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417738576 PECOS PAC ID: 7416304514 Enrollment ID: I20231110002841 |
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