Mindful Support Pllc | |
110 N Brockway St Ste 300 Palatine IL 60067-5063 | |
(630) 640-3539 | |
Not Available |
Full Name | Mindful Support Pllc |
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Speciality | Counselor |
Location | 110 N Brockway St Ste 300, Palatine, Illinois |
Authorized Official Name and Position | Tracy Lanier (CLINICAL DIRECTOR) |
Authorized Official Contact | 3125364495 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mindful Support Pllc 38w463 Clubhouse Dr St Charles IL 60175-6178 Ph: (630) 640-3539 | Mindful Support Pllc 110 N Brockway St Ste 300 Palatine IL 60067-5063 Ph: (630) 640-3539 |
NPI Number | 1003689217 |
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Provider Enumeration Date | 10/31/2023 |
Last Update Date | 10/31/2023 |
Certification Date | 10/31/2023 |
Medicare PECOS PAC ID | 3870936842 |
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Medicare Enrollment ID | O20240206004209 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003689217 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Maria Arcadia Rocha |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528430899 PECOS PAC ID: 0143503623 Enrollment ID: I20170207001779 |
Provider Name | Tracy A Lanier |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417228560 PECOS PAC ID: 7315368958 Enrollment ID: I20200605001958 |
Provider Name | Veesser Mehry Aminpour |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1215552393 PECOS PAC ID: 8426590480 Enrollment ID: I20240605001544 |
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