| Mindful Therapy Services Pllc | |
|
917 Micahs Way N Spring Lake NC 28390-6001 | |
| (910) 580-4357 | |
| Not Available |
| Full Name | Mindful Therapy Services Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 917 Micahs Way N, Spring Lake, North Carolina |
| Authorized Official Name and Position | Desirrae Anderson-harris (OWNER) |
| Authorized Official Contact | 9105804357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Therapy Services Pllc 917 Micahs Way N Spring Lake NC 28390-6001 Ph: () - | Mindful Therapy Services Pllc 917 Micahs Way N Spring Lake NC 28390-6001 Ph: (910) 580-4357 |
| NPI Number | 1548995699 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 07/22/2022 |
| Certification Date | 07/22/2022 |
| Medicare PECOS PAC ID | 9931582020 |
|---|---|
| Medicare Enrollment ID | O20220823002075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548995699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Desirrae Anderson-harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104208917 PECOS PAC ID: 0840673935 Enrollment ID: I20220823002287 |
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