Mindful Therapy Services Pllc | |
917 Micahs Way N Spring Lake NC 28390-6001 | |
(910) 580-4357 | |
Not Available |
Full Name | Mindful Therapy Services Pllc |
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Speciality | Social Worker |
Location | 917 Micahs Way N, Spring Lake, North Carolina |
Authorized Official Name and Position | Desirrae Anderson-harris (OWNER) |
Authorized Official Contact | 9105804357 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mindful Therapy Services Pllc 917 Micahs Way N Spring Lake NC 28390-6001 Ph: () - | Mindful Therapy Services Pllc 917 Micahs Way N Spring Lake NC 28390-6001 Ph: (910) 580-4357 |
NPI Number | 1548995699 |
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Provider Enumeration Date | 07/22/2022 |
Last Update Date | 07/22/2022 |
Certification Date | 07/22/2022 |
Medicare PECOS PAC ID | 9931582020 |
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Medicare Enrollment ID | O20220823002075 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548995699 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Desirrae Anderson-harris |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1104208917 PECOS PAC ID: 0840673935 Enrollment ID: I20220823002287 |
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