| Mindful Support And Mental Health Solutions Llc | |
|
708 Carriage Ln Merritt Island FL 32952-4149 | |
| (321) 206-5375 | |
| (321) 251-6622 |
| Full Name | Mindful Support And Mental Health Solutions Llc |
|---|---|
| Speciality | Psychologist |
| Location | 708 Carriage Ln, Merritt Island, Florida |
| Authorized Official Name and Position | Beverley Calderone (OWNER) |
| Authorized Official Contact | 3212065375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Support And Mental Health Solutions Llc 708 Carriage Ln Merritt Island FL 32952-4149 Ph: (321) 206-5375 | Mindful Support And Mental Health Solutions Llc 708 Carriage Ln Merritt Island FL 32952-4149 Ph: (321) 206-5375 |
| NPI Number | 1467211425 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Medicare PECOS PAC ID | 1850732348 |
|---|---|
| Medicare Enrollment ID | O20240515001679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467211425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Rebecca Jane Jacobson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558936971 PECOS PAC ID: 5890144307 Enrollment ID: I20231208003413 |
| Provider Name | Alyssa Bass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881252716 PECOS PAC ID: 3577904069 Enrollment ID: I20240515001731 |
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