| Mind Your Mentality | |
|
221 Serenity Shores Rd Benton KY 42025-6043 | |
| (270) 610-1181 | |
| Not Available |
| Full Name | Mind Your Mentality |
|---|---|
| Speciality | Social Worker |
| Location | 221 Serenity Shores Rd, Benton, Kentucky |
| Authorized Official Name and Position | Joseph L Hull (CEO) |
| Authorized Official Contact | 2706101181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Your Mentality 221 Serenity Shores Rd Benton KY 42025-6043 Ph: (270) 610-1181 | Mind Your Mentality 221 Serenity Shores Rd Benton KY 42025-6043 Ph: (270) 610-1181 |
| NPI Number | 1417703893 |
|---|---|
| Provider Enumeration Date | 04/26/2024 |
| Last Update Date | 09/05/2024 |
| Certification Date | 09/05/2024 |
| Medicare PECOS PAC ID | 5193265064 |
|---|---|
| Medicare Enrollment ID | O20240905003717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417703893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Joseph L Hull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245084003 PECOS PAC ID: 7911347752 Enrollment ID: I20240426003084 |
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