| Mind, Body & Soul Counseling, Llc | |
|
1326 Creston Park Dr Janesville WI 53545-1156 | |
| (608) 931-7224 | |
| Not Available |
| Full Name | Mind, Body & Soul Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1326 Creston Park Dr, Janesville, Wisconsin |
| Authorized Official Name and Position | Amanda Isunza (OWNER) |
| Authorized Official Contact | 6089317224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind, Body & Soul Counseling, Llc 1326 Creston Park Dr Janesville WI 53545-1156 Ph: () - | Mind, Body & Soul Counseling, Llc 1326 Creston Park Dr Janesville WI 53545-1156 Ph: (608) 931-7224 |
| NPI Number | 1376289439 |
|---|---|
| Provider Enumeration Date | 05/10/2022 |
| Last Update Date | 05/10/2022 |
| Certification Date | 05/10/2022 |
| Medicare PECOS PAC ID | 9436505948 |
|---|---|
| Medicare Enrollment ID | O20231019001175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376289439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amanda Isunza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881085959 PECOS PAC ID: 9234480260 Enrollment ID: I20181001002324 |
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