| Mindful Possibilities Llc Robert Corey Boes Sole Mbr | |
|
905 W Cantey St Fort Worth TX 76110-3205 | |
| (817) 382-1876 | |
| Not Available |
| Full Name | Mindful Possibilities Llc Robert Corey Boes Sole Mbr |
|---|---|
| Speciality | Clinic/Center |
| Location | 905 W Cantey St, Fort Worth, Texas |
| Authorized Official Name and Position | Robert Corey Boes (FOUNDER) |
| Authorized Official Contact | 8173821876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Possibilities Llc Robert Corey Boes Sole Mbr 905 W Cantey St Fort Worth TX 76110-3205 Ph: (817) 382-1876 | Mindful Possibilities Llc Robert Corey Boes Sole Mbr 905 W Cantey St Fort Worth TX 76110-3205 Ph: (817) 382-1876 |
| NPI Number | 1821730359 |
|---|---|
| Provider Enumeration Date | 04/13/2022 |
| Last Update Date | 07/22/2024 |
| Certification Date | 07/22/2024 |
| Medicare PECOS PAC ID | 9638541196 |
|---|---|
| Medicare Enrollment ID | O20230209000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821730359 | NPI | - | NPPES |
| Provider Name | Robert Corey Boes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558827949 PECOS PAC ID: 2365814829 Enrollment ID: I20230209000418 |
| Provider Name | Crystal Urias Valdez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033846233 PECOS PAC ID: 6103298666 Enrollment ID: I20230209000639 |
| Provider Name | Gabriela Ana Padilla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225738834 PECOS PAC ID: 3779936869 Enrollment ID: I20240124004576 |
| Provider Name | Madeline Brooke James |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548989270 PECOS PAC ID: 6507219599 Enrollment ID: I20240125003367 |
| Provider Name | Lindsey J Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356102321 PECOS PAC ID: 3274986971 Enrollment ID: I20240130000828 |
| Provider Name | Ashley Ketchum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366204414 PECOS PAC ID: 8820437189 Enrollment ID: I20240418003660 |
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