| Minds That Matter Llc | |
|
808 Eden Way N Chesapeake VA 23320-0745 | |
| (757) 354-3161 | |
| Not Available |
| Full Name | Minds That Matter Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 808 Eden Way N, Chesapeake, Virginia |
| Authorized Official Name and Position | Stacie Anita Pittman (PMHNP-BC) |
| Authorized Official Contact | 7575316485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minds That Matter Llc 1580 Crystal Lake Dr Portsmouth VA 23701-3624 Ph: (757) 531-6485 | Minds That Matter Llc 808 Eden Way N Chesapeake VA 23320-0745 Ph: (757) 354-3161 |
| NPI Number | 1124883434 |
|---|---|
| Provider Enumeration Date | 02/15/2024 |
| Last Update Date | 02/15/2024 |
| Certification Date | 02/15/2024 |
| Medicare PECOS PAC ID | 0345787420 |
|---|---|
| Medicare Enrollment ID | O20240807001409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124883434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Stacie Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144899592 PECOS PAC ID: 3870980758 Enrollment ID: I20220422001695 |
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