| Mindful Life Practice, Llc | |
|
221 Garland St Traverse City MI 49684-2372 | |
| (231) 486-0805 | |
| Not Available |
| Full Name | Mindful Life Practice, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 221 Garland St, Traverse City, Michigan |
| Authorized Official Name and Position | Linda Smith (PARTNER) |
| Authorized Official Contact | 2314860805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Life Practice, Llc 221 Garland St Traverse City MI 49684-2372 Ph: (231) 486-0805 | Mindful Life Practice, Llc 221 Garland St Traverse City MI 49684-2372 Ph: (231) 486-0805 |
| NPI Number | 1053781765 |
|---|---|
| Provider Enumeration Date | 10/07/2015 |
| Last Update Date | 01/17/2025 |
| Certification Date | 01/17/2025 |
| Medicare PECOS PAC ID | 3971033309 |
|---|---|
| Medicare Enrollment ID | O20250213002988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053781765 | NPI | - | NPPES |
| Provider Name | Stephanie D Berger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336420108 PECOS PAC ID: 0446482863 Enrollment ID: I20140416001717 |
| Provider Name | Susan A Kirt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962826982 PECOS PAC ID: 9335423235 Enrollment ID: I20170221000430 |
| Provider Name | Linda Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407154719 PECOS PAC ID: 4880124213 Enrollment ID: I20250213003154 |
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