| Mood By Kim | |
|
7901 4th St N Ste 300 St Petersburg FL 33702-4399 | |
| (623) 777-7551 | |
| (623) 666-6612 |
| Full Name | Mood By Kim |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 7901 4th St N Ste 300, St Petersburg, Florida |
| Authorized Official Name and Position | Kimberly Cochran (OWNER/PROVIDER) |
| Authorized Official Contact | 6237777551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mood By Kim 8194 W Deer Valley Rd Ste 106 Peoria AZ 85382-2127 Ph: (623) 777-7551 | Mood By Kim 7901 4th St N Ste 300 St Petersburg FL 33702-4399 Ph: (623) 777-7551 |
| NPI Number | 1497380604 |
|---|---|
| Provider Enumeration Date | 03/08/2020 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497380604 | NPI | - | NPPES |
| 993686 | Medicaid | AZ | |
| 06543815 | Medicaid | NY | |
| 2156425 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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