| Mindflower Limited Liability Company | |
|
1717 N St Nw Washington DC 20036-2827 | |
| (202) 499-6228 | |
| Not Available |
| Full Name | Mindflower Limited Liability Company |
|---|---|
| Speciality | Counselor |
| Location | 1717 N St Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Sur Elias (ADMIN) |
| Authorized Official Contact | 2024996228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindflower Limited Liability Company 2020 Pennsylvania Ave Nw # 131 Washington DC 20006-1811 Ph: (202) 499-6228 | Mindflower Limited Liability Company 1717 N St Nw Washington DC 20036-2827 Ph: (202) 499-6228 |
| NPI Number | 1801460977 |
|---|---|
| Provider Enumeration Date | 05/13/2021 |
| Last Update Date | 08/09/2023 |
| Certification Date | 08/09/2023 |
| Medicare PECOS PAC ID | 8527461540 |
|---|---|
| Medicare Enrollment ID | O20210728000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801460977 | NPI | - | NPPES |
| 040868299 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Danielle Nicole Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740848795 PECOS PAC ID: 2769885789 Enrollment ID: I20210728000474 |
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