| Mindful Life In Action | |
|
380 Cline Ave Ste 3 Mansfield OH 44907-1056 | |
| (567) 241-1543 | |
| Not Available |
| Full Name | Mindful Life In Action |
|---|---|
| Speciality | Counselor |
| Location | 380 Cline Ave Ste 3, Mansfield, Ohio |
| Authorized Official Name and Position | Mary M Cox (THERAPIST) |
| Authorized Official Contact | 5672411543 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Life In Action Po Box 290 Shelby OH 44875-0290 Ph: (567) 241-1543 | Mindful Life In Action 380 Cline Ave Ste 3 Mansfield OH 44907-1056 Ph: (567) 241-1543 |
| NPI Number | 1902234453 |
|---|---|
| Provider Enumeration Date | 10/21/2013 |
| Last Update Date | 05/19/2022 |
| Certification Date | 05/19/2022 |
| Medicare PECOS PAC ID | 2769797992 |
|---|---|
| Medicare Enrollment ID | O20150818004484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902234453 | NPI | - | NPPES |
| 0906532 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ICDC131026 (Ohio) | Secondary |
| 101YM0800X | Counselor - Mental Health | I1200473 (Ohio) | Primary |
| Provider Name | Elizabeth A Rich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295983377 PECOS PAC ID: 7517004302 Enrollment ID: I20091028000043 |
| Provider Name | Mary M Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629338298 PECOS PAC ID: 4183876006 Enrollment ID: I20121128000469 |
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