| Mindful Vibrance, LLC | |
|
10 Westowne St Liberty MO 64068-1166 | |
| (816) 466-5231 | |
| (816) 379-6835 |
| Full Name | Mindful Vibrance, LLC |
|---|---|
| Speciality | Social Worker |
| Location | 10 Westowne St, Liberty, Missouri |
| Authorized Official Name and Position | Michele Roberts (OWNER) |
| Authorized Official Contact | 8164665231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Vibrance, LLC 10 Westowne St Liberty MO 64068-1166 Ph: (816) 466-5231 | Mindful Vibrance, LLC 10 Westowne St Liberty MO 64068-1166 Ph: (816) 466-5231 |
| NPI Number | 1174300255 |
|---|---|
| Provider Enumeration Date | 09/12/2023 |
| Last Update Date | 01/31/2024 |
| Certification Date | 01/31/2024 |
| Medicare PECOS PAC ID | 4385092592 |
|---|---|
| Medicare Enrollment ID | O20231129001028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174300255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Michele Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326403783 PECOS PAC ID: 3173806098 Enrollment ID: I20170220000260 |
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