| Therapeutic Mind Shift | |
|
222 County Road 608 Angleton TX 77515-2063 | |
| (979) 248-4542 | |
| Not Available |
| Full Name | Therapeutic Mind Shift |
|---|---|
| Speciality | Social Worker |
| Location | 222 County Road 608, Angleton, Texas |
| Authorized Official Name and Position | Dequita L Frost (OWNER) |
| Authorized Official Contact | 9792484542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Mind Shift 222 County Road 608 Angleton TX 77515-2063 Ph: (979) 248-4542 | Therapeutic Mind Shift 222 County Road 608 Angleton TX 77515-2063 Ph: (979) 248-4542 |
| NPI Number | 1871346866 |
|---|---|
| Provider Enumeration Date | 04/09/2024 |
| Last Update Date | 05/31/2024 |
| Certification Date | 05/31/2024 |
| Medicare PECOS PAC ID | 2062954332 |
|---|---|
| Medicare Enrollment ID | O20240603001949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871346866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dequita L Frost |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770285686 PECOS PAC ID: 0840653119 Enrollment ID: I20230905000881 |
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