| Myndspace Mental Health Education & Consulting, Llc | |
|
4 Carriage Ln Ste 200 Charleston SC 29407-6049 | |
| (803) 351-8252 | |
| Not Available |
| Full Name | Myndspace Mental Health Education & Consulting, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4 Carriage Ln Ste 200, Charleston, South Carolina |
| Authorized Official Name and Position | Cerrissa Michelle Hugie (OWNER/PROVIDER) |
| Authorized Official Contact | 8033518252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myndspace Mental Health Education & Consulting, Llc 4 Carriage Ln Ste 200 Charleston SC 29407-6049 Ph: (803) 351-8252 | Myndspace Mental Health Education & Consulting, Llc 4 Carriage Ln Ste 200 Charleston SC 29407-6049 Ph: (803) 351-8252 |
| NPI Number | 1215541669 |
|---|---|
| Provider Enumeration Date | 09/03/2020 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/28/2024 |
| Medicare PECOS PAC ID | 7517367519 |
|---|---|
| Medicare Enrollment ID | O20210614000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215541669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Steven Gerald Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356459218 PECOS PAC ID: 8820099658 Enrollment ID: I20070123000070 |
| Provider Name | Cerrissa Michelle Hugie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538695846 PECOS PAC ID: 2860751260 Enrollment ID: I20180110001385 |
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