| Mindful Therapy Solutions Lcsw Pllc | |
|
1749 Victory Blvd Second Floor Staten Island NY 10314-3552 | |
| (718) 764-8278 | |
| Not Available |
| Full Name | Mindful Therapy Solutions Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1749 Victory Blvd, Staten Island, New York |
| Authorized Official Name and Position | Elissa Donner (OWNER/LCSW) |
| Authorized Official Contact | 7187648278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Therapy Solutions Lcsw Pllc 1749 Victory Blvd Second Floor Staten Island NY 10314-3552 Ph: () - | Mindful Therapy Solutions Lcsw Pllc 1749 Victory Blvd Second Floor Staten Island NY 10314-3552 Ph: (718) 764-8278 |
| NPI Number | 1578999546 |
|---|---|
| Provider Enumeration Date | 09/22/2013 |
| Last Update Date | 09/22/2013 |
| Medicare PECOS PAC ID | 0941431209 |
|---|---|
| Medicare Enrollment ID | O20140331000219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578999546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 079574 (New York) | Primary |
| Provider Name | Elissa Donner Guzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093070872 PECOS PAC ID: 9234358938 Enrollment ID: I20140911000628 |
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