| Mindful Mental Health Services - Fl Gulf Sw Llc | |
|
1945 17th St Sarasota FL 34234-7520 | |
| (941) 210-0384 | |
| (941) 210-0783 |
| Full Name | Mindful Mental Health Services - Fl Gulf Sw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1945 17th St, Sarasota, Florida |
| Authorized Official Name and Position | Ahron Steinberg (CEO) |
| Authorized Official Contact | 9412100384 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Mental Health Services - Fl Gulf Sw Llc 1945 17th St Sarasota FL 34234-7520 Ph: (941) 210-0384 | Mindful Mental Health Services - Fl Gulf Sw Llc 1945 17th St Sarasota FL 34234-7520 Ph: (941) 210-0384 |
| NPI Number | 1568121267 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 12/10/2021 |
| Certification Date | 12/10/2021 |
| Medicare PECOS PAC ID | 9234523325 |
|---|---|
| Medicare Enrollment ID | O20220307001924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568121267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Joan Vail |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013116136 PECOS PAC ID: 7012905508 Enrollment ID: I20040504000371 |
| Provider Name | Mark Anthony Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972990844 PECOS PAC ID: 0941520795 Enrollment ID: I20150519002750 |
| Provider Name | Debra Dean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932118841 PECOS PAC ID: 2668370586 Enrollment ID: I20160630000887 |
| Provider Name | Christopher Anthony Wilcox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891229712 PECOS PAC ID: 6507139524 Enrollment ID: I20170913001040 |
| Provider Name | Aritha F Yarborough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922429992 PECOS PAC ID: 9739453945 Enrollment ID: I20170926002984 |
| Provider Name | David Adam Koerner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346351392 PECOS PAC ID: 0042647885 Enrollment ID: I20200217004605 |
| Provider Name | John Druilhet Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942469648 PECOS PAC ID: 5496786303 Enrollment ID: I20201112000157 |
| Provider Name | Samantha Mangino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073166757 PECOS PAC ID: 7911314745 Enrollment ID: I20210323002488 |
| Provider Name | Amy S Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972189041 PECOS PAC ID: 0749672046 Enrollment ID: I20220119000053 |
| Provider Name | Kariana Marie Yulfo Matias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114662871 PECOS PAC ID: 9133507098 Enrollment ID: I20220606000169 |
| Provider Name | Jennifer Seward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457007320 PECOS PAC ID: 1254710080 Enrollment ID: I20220623003471 |
| Provider Name | Karen Elizabeth Vittone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760139851 PECOS PAC ID: 5395127344 Enrollment ID: I20220808001013 |
| Provider Name | Joann Bova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710692108 PECOS PAC ID: 8426429515 Enrollment ID: I20230127002835 |
| Provider Name | Charlene Kremm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407308158 PECOS PAC ID: 8729442744 Enrollment ID: I20230910000002 |
| Provider Name | Alison Michele Piller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790969673 PECOS PAC ID: 8820447394 Enrollment ID: I20231208001865 |
| Provider Name | Shane K Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689822686 PECOS PAC ID: 4880038637 Enrollment ID: I20240220002322 |
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