| Mindwave Therapy | |
|
2020 W 3rd St Ste 500c Little Rock AR 72205-4466 | |
| (501) 492-6860 | |
| (501) 406-3671 |
| Full Name | Mindwave Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 2020 W 3rd St Ste 500c, Little Rock, Arkansas |
| Authorized Official Name and Position | Maci Nicole Scudder (OWNER) |
| Authorized Official Contact | 5014926860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindwave Therapy 2020 W 3rd St Ste 500c Little Rock AR 72205-4466 Ph: (501) 492-6860 | Mindwave Therapy 2020 W 3rd St Ste 500c Little Rock AR 72205-4466 Ph: (501) 492-6860 |
| NPI Number | 1669254181 |
|---|---|
| Provider Enumeration Date | 10/18/2023 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 3274974654 |
|---|---|
| Medicare Enrollment ID | O20240516001243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669254181 | NPI | - | NPPES |
| 1326524927 | Medicaid | AR | |
| 1669524181 | Medicaid | AR |
| Provider Name | Maci Scudder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326524927 PECOS PAC ID: 0648657346 Enrollment ID: I20220518002935 |
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