| Mindspace Services Llc | |
|
252 Bay Ridge Pkwy Apt 4d Brooklyn NY 11209-2456 | |
| (347) 671-1308 | |
| Not Available |
| Full Name | Mindspace Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 252 Bay Ridge Pkwy Apt 4d, Brooklyn, New York |
| Authorized Official Name and Position | Andy Benchemmar (SOLE MBR) |
| Authorized Official Contact | 3476711308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindspace Services Llc 252 Bay Ridge Pkwy Apt 4d Brooklyn NY 11209-2456 Ph: (347) 671-1308 | Mindspace Services Llc 252 Bay Ridge Pkwy Apt 4d Brooklyn NY 11209-2456 Ph: (347) 671-1308 |
| NPI Number | 1679285696 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 12/21/2022 |
| Certification Date | 12/21/2022 |
| Medicare PECOS PAC ID | 1052782901 |
|---|---|
| Medicare Enrollment ID | O20230201000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679285696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Andy Benchemmar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740838754 PECOS PAC ID: 2961873815 Enrollment ID: I20230201000592 |
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