| Mindful Wellness Psychological Services, Llc | |
|
7575 Leavitt Rd Amherst OH 44001-2701 | |
| (440) 773-3032 | |
| Not Available |
| Full Name | Mindful Wellness Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7575 Leavitt Rd, Amherst, Ohio |
| Authorized Official Name and Position | Evelyn Garland (CONTRACTING MANAGER) |
| Authorized Official Contact | 4042135329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Wellness Psychological Services, Llc 1438 W 30th St Lorain OH 44052-4352 Ph: (440) 773-7277 | Mindful Wellness Psychological Services, Llc 7575 Leavitt Rd Amherst OH 44001-2701 Ph: (440) 773-3032 |
| NPI Number | 1346836640 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 12/21/2020 |
| Certification Date | 12/21/2020 |
| Medicare PECOS PAC ID | 6103214515 |
|---|---|
| Medicare Enrollment ID | O20211103002153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346836640 | NPI | - | NPPES |
| 1801124730 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Denise Eacott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801124730 PECOS PAC ID: 2062557473 Enrollment ID: I20211103002210 |
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