| Mynd Matters | |
|
9201 Arboretum Pkwy Ste 110 North Chesterfield VA 23236-5403 | |
| (804) 320-0101 | |
| (804) 320-0808 |
| Full Name | Mynd Matters |
|---|---|
| Speciality | Psychologist |
| Location | 9201 Arboretum Pkwy Ste 110, North Chesterfield, Virginia |
| Authorized Official Name and Position | David Dameron (OWNER) |
| Authorized Official Contact | 8043200101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mynd Matters 9201 Arboretum Pkwy Ste 110 North Chesterfield VA 23236-5403 Ph: (804) 320-0101 | Mynd Matters 9201 Arboretum Pkwy Ste 110 North Chesterfield VA 23236-5403 Ph: (804) 320-0101 |
| NPI Number | 1285130633 |
|---|---|
| Provider Enumeration Date | 04/04/2018 |
| Last Update Date | 04/04/2018 |
| Medicare PECOS PAC ID | 3375894603 |
|---|---|
| Medicare Enrollment ID | O20180925002699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285130633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| Provider Name | David B Dameron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184645939 PECOS PAC ID: 9739147141 Enrollment ID: I20050729000926 |
| Provider Name | Jordan M Kilgour |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609062900 PECOS PAC ID: 6103902424 Enrollment ID: I20080327000347 |
| Provider Name | Cynthia L Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356419295 PECOS PAC ID: 6406901057 Enrollment ID: I20090902000596 |
| Provider Name | Donald Koehler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528202371 PECOS PAC ID: 7012066301 Enrollment ID: I20130918000140 |
| Provider Name | Andrea R Weisman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124102884 PECOS PAC ID: 1951616234 Enrollment ID: I20150814014661 |
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