| Mindful Change, Llc | |
|
403 Brian Dr West Monroe LA 71291-9466 | |
| (318) 805-3433 | |
| Not Available |
| Full Name | Mindful Change, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 403 Brian Dr, West Monroe, Louisiana |
| Authorized Official Name and Position | Sarah Dean Roy (OWNER OF MINDFUL CHANGE, LLC) |
| Authorized Official Contact | 3188053433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Change, Llc 403 Brian Dr West Monroe LA 71291-9466 Ph: (318) 805-3433 | Mindful Change, Llc 403 Brian Dr West Monroe LA 71291-9466 Ph: (318) 805-3433 |
| NPI Number | 1346909967 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 12/10/2021 |
| Certification Date | 12/10/2021 |
| Medicare PECOS PAC ID | 7113318387 |
|---|---|
| Medicare Enrollment ID | O20211222002080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346909967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sarah D Roy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942759402 PECOS PAC ID: 1951631449 Enrollment ID: I20190926000463 |
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