| Beaming Mind Psychology Llc | |
|
1101 Tamiami Trl S Ste 215a-1 Venice FL 34285-4133 | |
| (941) 842-3837 | |
| Not Available |
| Full Name | Beaming Mind Psychology Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1101 Tamiami Trl S Ste 215a-1, Venice, Florida |
| Authorized Official Name and Position | Veronica Patricia Medina (OWNER) |
| Authorized Official Contact | 4844084646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaming Mind Psychology Llc 14370 59th Cir E Bradenton FL 34211-0740 Ph: (941) 842-3837 | Beaming Mind Psychology Llc 1101 Tamiami Trl S Ste 215a-1 Venice FL 34285-4133 Ph: (941) 842-3837 |
| NPI Number | 1285406066 |
|---|---|
| Provider Enumeration Date | 10/25/2023 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 1153777024 |
|---|---|
| Medicare Enrollment ID | O20231030000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285406066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Veronica P Medina |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053804708 PECOS PAC ID: 4385981190 Enrollment ID: I20190131001569 |
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