| The Mindful Oasis Co. | |
|
11891 Neelyton Rd Shade Gap PA 17255-9247 | |
| (717) 489-2949 | |
| Not Available |
| Full Name | The Mindful Oasis Co. |
|---|---|
| Speciality | Social Worker |
| Location | 11891 Neelyton Rd, Shade Gap, Pennsylvania |
| Authorized Official Name and Position | Nikole Boston (OWNER) |
| Authorized Official Contact | 7174892949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mindful Oasis Co. 11891 Neelyton Rd Shade Gap PA 17255-9247 Ph: () - | The Mindful Oasis Co. 11891 Neelyton Rd Shade Gap PA 17255-9247 Ph: (717) 489-2949 |
| NPI Number | 1225703226 |
|---|---|
| Provider Enumeration Date | 08/11/2021 |
| Last Update Date | 08/03/2023 |
| Certification Date | 08/03/2023 |
| Medicare PECOS PAC ID | 2163805474 |
|---|---|
| Medicare Enrollment ID | O20220819000976 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225703226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nicole Matero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922503200 PECOS PAC ID: 3870858947 Enrollment ID: I20180521002896 |
| Provider Name | Nikole A Boston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720599434 PECOS PAC ID: 3971925074 Enrollment ID: I20200618001343 |
| Provider Name | Kathleen Rubright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972910925 PECOS PAC ID: 8426465907 Enrollment ID: I20210330000233 |
| Provider Name | Vikki Jean Higgins |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265145577 PECOS PAC ID: 1850736141 Enrollment ID: I20240227000078 |