| Mindful Oasis Llc | |
|
3500 Virginia Beach Blvd Ste 202 Virginia Beach VA 23452-4445 | |
| (757) 720-1040 | |
| (757) 720-1041 |
| Full Name | Mindful Oasis Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3500 Virginia Beach Blvd Ste 202, Virginia Beach, Virginia |
| Authorized Official Name and Position | Mariam Bouanane-smith (OWNER) |
| Authorized Official Contact | 7577201060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Oasis Llc 3500 Virginia Beach Blvd Ste 202 Virginia Beach VA 23452-4445 Ph: (757) 720-1040 | Mindful Oasis Llc 3500 Virginia Beach Blvd Ste 202 Virginia Beach VA 23452-4445 Ph: (757) 720-1040 |
| NPI Number | 1366260150 |
|---|---|
| Provider Enumeration Date | 09/30/2024 |
| Last Update Date | 07/03/2025 |
| Certification Date | 07/03/2025 |
| Medicare PECOS PAC ID | 3779010400 |
|---|---|
| Medicare Enrollment ID | O20241219001685 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366260150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mariam Sophia Bouanane-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053024026 PECOS PAC ID: 2769837608 Enrollment ID: I20231012000187 |
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