| Resilience, Grit And Mindset Llc | |
|
5115 W Dakota St Philadelphia PA 19131-2414 | |
| (215) 908-3613 | |
| Not Available |
| Full Name | Resilience, Grit And Mindset Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5115 W Dakota St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Joseph Gary Williams (PSYCHOTHERAPT) |
| Authorized Official Contact | 2159083613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilience, Grit And Mindset Llc 5115 W Dakota St Philadelphia PA 19131-2414 Ph: (215) 908-3613 | Resilience, Grit And Mindset Llc 5115 W Dakota St Philadelphia PA 19131-2414 Ph: (215) 908-3613 |
| NPI Number | 1619747128 |
|---|---|
| Provider Enumeration Date | 01/05/2024 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Medicare PECOS PAC ID | 5597100610 |
|---|---|
| Medicare Enrollment ID | O20240228003987 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619747128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Joseph Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073999512 PECOS PAC ID: 8921443045 Enrollment ID: I20240228004139 |
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