| Mindspace Clinical Counseling Llc | |
|
9711 Washingtonian Blvd Ste 550 Gaithersburg MD 20878-5789 | |
| (240) 394-6530 | |
| Not Available |
| Full Name | Mindspace Clinical Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9711 Washingtonian Blvd Ste 550, Gaithersburg, Maryland |
| Authorized Official Name and Position | Esther H Kim (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2403946530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindspace Clinical Counseling Llc 9711 Washingtonian Blvd Ste 550 Gaithersburg MD 20878-5789 Ph: (202) 487-3813 | Mindspace Clinical Counseling Llc 9711 Washingtonian Blvd Ste 550 Gaithersburg MD 20878-5789 Ph: (240) 394-6530 |
| NPI Number | 1245966951 |
|---|---|
| Provider Enumeration Date | 07/26/2022 |
| Last Update Date | 01/31/2023 |
| Certification Date | 01/31/2023 |
| Medicare PECOS PAC ID | 7214304138 |
|---|---|
| Medicare Enrollment ID | O20230109001876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245966951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Esther Hyuna Kim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235887050 PECOS PAC ID: 3678940293 Enrollment ID: I20230109002190 |
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