| Center For A Healthy Mind And Wellbeing Llc | |
|
6817 Southpoint Pkwy Ste 1301 Jacksonville FL 32216-6297 | |
| (904) 527-8777 | |
| (904) 379-5744 |
| Full Name | Center For A Healthy Mind And Wellbeing Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6817 Southpoint Pkwy Ste 1301, Jacksonville, Florida |
| Authorized Official Name and Position | Ginger Hudnall (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 9045278777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For A Healthy Mind And Wellbeing Llc 1677 Wells Rd Suite A Orange Park FL 32073-6799 Ph: (904) 272-0043 | Center For A Healthy Mind And Wellbeing Llc 6817 Southpoint Pkwy Ste 1301 Jacksonville FL 32216-6297 Ph: (904) 527-8777 |
| NPI Number | 1710243571 |
|---|---|
| Provider Enumeration Date | 04/05/2012 |
| Last Update Date | 01/31/2025 |
| Certification Date | 01/31/2025 |
| Medicare PECOS PAC ID | 0143476044 |
|---|---|
| Medicare Enrollment ID | O20120808000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710243571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME108768 (Florida) | Primary |
| Provider Name | Louise A Axelberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124074729 PECOS PAC ID: 6901903558 Enrollment ID: I20070516000532 |
| Provider Name | Marcus Decarvalho |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427213727 PECOS PAC ID: 6002088457 Enrollment ID: I20120816000122 |
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