| Mindset Therapy And Wellness | |
|
6431 Dante Ln Nw Albuquerque NM 87114-5024 | |
| (505) 239-7576 | |
| Not Available |
| Full Name | Mindset Therapy And Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 6431 Dante Ln Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Marissa Diaz (OWNER) |
| Authorized Official Contact | 5052397576 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindset Therapy And Wellness Po Box 45681 Rio Rancho NM 87174-5681 Ph: (505) 226-1960 | Mindset Therapy And Wellness 6431 Dante Ln Nw Albuquerque NM 87114-5024 Ph: (505) 239-7576 |
| NPI Number | 1710652755 |
|---|---|
| Provider Enumeration Date | 08/11/2021 |
| Last Update Date | 09/23/2021 |
| Certification Date | 09/23/2021 |
| Medicare PECOS PAC ID | 2668879826 |
|---|---|
| Medicare Enrollment ID | O20210930002004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710652755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marissa Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427541507 PECOS PAC ID: 5395142558 Enrollment ID: I20210930002245 |
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