| Sound Mind Healthcare Services Llc | |
|
9720 Capital Ct Ste 100 Manassas VA 20110-2049 | |
| (703) 216-6621 | |
| (571) 730-1461 |
| Full Name | Sound Mind Healthcare Services Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 9720 Capital Ct Ste 100, Manassas, Virginia |
| Authorized Official Name and Position | Patience Otaigbe (NURSE PRACTITIONER) |
| Authorized Official Contact | 7032166621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound Mind Healthcare Services Llc 9720 Capital Ct Ste 100 Manassas VA 20110-2049 Ph: (703) 216-6621 | Sound Mind Healthcare Services Llc 9720 Capital Ct Ste 100 Manassas VA 20110-2049 Ph: (703) 216-6621 |
| NPI Number | 1497437883 |
|---|---|
| Provider Enumeration Date | 08/03/2023 |
| Last Update Date | 08/03/2023 |
| Certification Date | 08/03/2023 |
| Medicare PECOS PAC ID | 6406203561 |
|---|---|
| Medicare Enrollment ID | O20231110000764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497437883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Patience Otaigbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811521461 PECOS PAC ID: 6305256934 Enrollment ID: I20201110000777 |
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