| Mindspace Counseling Llc | |
|
204 Brantley Harbor Dr St Augustine FL 32086-1822 | |
| (203) 490-6860 | |
| (904) 574-4096 |
| Full Name | Mindspace Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 204 Brantley Harbor Dr, St Augustine, Florida |
| Authorized Official Name and Position | Dani M Dimitrova (OWNER) |
| Authorized Official Contact | 2033003335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindspace Counseling Llc 204 Brantley Harbor Dr St Augustine FL 32086-1822 Ph: (203) 300-3335 | Mindspace Counseling Llc 204 Brantley Harbor Dr St Augustine FL 32086-1822 Ph: (203) 490-6860 |
| NPI Number | 1740937655 |
|---|---|
| Provider Enumeration Date | 03/10/2022 |
| Last Update Date | 03/10/2022 |
| Certification Date | 03/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740937655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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