| Mindfully, Llc | |
|
9850 Von Allmen Ct Ste 201 Louisville KY 40241-2855 | |
| (888) 830-0347 | |
| Not Available |
| Full Name | Mindfully, Llc |
|---|---|
| Speciality | Counselor |
| Location | 9850 Von Allmen Ct Ste 201, Louisville, Kentucky |
| Authorized Official Name and Position | Charles K Roberts (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8888300347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindfully, Llc 1251 Nilles Rd Ste 5 Fairfield OH 45014-7205 Ph: (888) 830-0347 | Mindfully, Llc 9850 Von Allmen Ct Ste 201 Louisville KY 40241-2855 Ph: (888) 830-0347 |
| NPI Number | 1891433975 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 3476606252 |
|---|---|
| Medicare Enrollment ID | O20231207001721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891433975 | NPI | - | NPPES |
| Provider Name | Kelly Fallon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194119941 PECOS PAC ID: 8224441803 Enrollment ID: I20201229002070 |
| Provider Name | Gregory Pratt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962876003 PECOS PAC ID: 8325341993 Enrollment ID: I20210702000366 |
| Provider Name | Rebecca Elliston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447727185 PECOS PAC ID: 2668877028 Enrollment ID: I20210823002640 |
| Provider Name | Joshua Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417304007 PECOS PAC ID: 3274976048 Enrollment ID: I20240208001926 |
| Provider Name | Caitlyn Grey Nelei-nunnemaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972978559 PECOS PAC ID: 5395188718 Enrollment ID: I20240226002944 |
| Provider Name | Margaret Scholle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831642693 PECOS PAC ID: 4284019191 Enrollment ID: I20240513001816 |
| Provider Name | Kathryn Caudill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679129373 PECOS PAC ID: 3173979861 Enrollment ID: I20240522000247 |
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