| Mindbridge Integrated Health Llc | |
|
244 Paddock Ct Delaware OH 43015-1317 | |
| (567) 674-1886 | |
| (833) 895-1836 |
| Full Name | Mindbridge Integrated Health Llc |
|---|---|
| Speciality | Social Worker |
| Location | 244 Paddock Ct, Delaware, Ohio |
| Authorized Official Name and Position | Greggory Stephens (OWNER/THERAPIST) |
| Authorized Official Contact | 5676741886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindbridge Integrated Health Llc 244 Paddock Ct Delaware OH 43015-1317 Ph: (567) 674-1886 | Mindbridge Integrated Health Llc 244 Paddock Ct Delaware OH 43015-1317 Ph: (567) 674-1886 |
| NPI Number | 1942078753 |
|---|---|
| Provider Enumeration Date | 12/12/2023 |
| Last Update Date | 12/12/2023 |
| Certification Date | 12/12/2023 |
| Medicare PECOS PAC ID | 6507302932 |
|---|---|
| Medicare Enrollment ID | O20240722003699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942078753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Teresa L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629028303 PECOS PAC ID: 7517971567 Enrollment ID: I20060130000677 |
| Provider Name | Gregg Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053508309 PECOS PAC ID: 5092023952 Enrollment ID: I20150928000549 |
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