Mothermind Psychology | |
19105 N Us Highway 41 Ste 300 Lutz FL 33549-4206 | |
(813) 400-0375 | |
(813) 616-6818 |
Full Name | Mothermind Psychology |
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Speciality | Psychologist |
Location | 19105 N Us Highway 41 Ste 300, Lutz, Florida |
Authorized Official Name and Position | Patricia Henandez Poudevida (OWNER/CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 8134000375 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mothermind Psychology 19105 N Us Highway 41 Ste 300 Lutz FL 33549-4206 Ph: (813) 400-0375 | Mothermind Psychology 19105 N Us Highway 41 Ste 300 Lutz FL 33549-4206 Ph: (813) 400-0375 |
NPI Number | 1992323778 |
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Provider Enumeration Date | 07/08/2020 |
Last Update Date | 04/28/2022 |
Certification Date | 04/28/2022 |
Medicare PECOS PAC ID | 3476907536 |
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Medicare Enrollment ID | O20230925000912 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992323778 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Patricia Hernandez Poudevida |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1740420405 PECOS PAC ID: 0840644902 Enrollment ID: I20230925000836 |
Provider Name | Bridget Young Browner |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1609053149 PECOS PAC ID: 4587001060 Enrollment ID: I20240319004021 |
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