| Mosaic Mental Wellness Llc | |
|
100 S Main St Ste 505 Wichita KS 67202-3738 | |
| (316) 688-8390 | |
| (316) 867-1718 |
| Full Name | Mosaic Mental Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 S Main St Ste 505, Wichita, Kansas |
| Authorized Official Name and Position | Yahayra Ortiz (OFFICE MANAGER) |
| Authorized Official Contact | 3166888390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Mental Wellness Llc 801 E Douglas Ave Fl 2 Wichita KS 67202-3548 Ph: (316) 688-8390 | Mosaic Mental Wellness Llc 100 S Main St Ste 505 Wichita KS 67202-3738 Ph: (316) 688-8390 |
| NPI Number | 1891348710 |
|---|---|
| Provider Enumeration Date | 07/19/2019 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Medicare PECOS PAC ID | 3476881053 |
|---|---|
| Medicare Enrollment ID | O20190820003471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891348710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jenni L Harshbarger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427385350 PECOS PAC ID: 6406112911 Enrollment ID: I20171204002220 |
| Provider Name | Josephine Lscsw Oldham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194137976 PECOS PAC ID: 1951669258 Enrollment ID: I20180122001551 |
| Provider Name | Tara K Galyardt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255857355 PECOS PAC ID: 7719361682 Enrollment ID: I20220826002771 |
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