| Mindfully Psychiatry Llc | |
|
10547 Montgomery Rd Ste 700 Montgomery OH 45242-4418 | |
| (513) 393-0300 | |
| Not Available |
| Full Name | Mindfully Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10547 Montgomery Rd Ste 700, Montgomery, Ohio |
| Authorized Official Name and Position | David Paul Miller (VICE PRESIDENT) |
| Authorized Official Contact | 7403608976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindfully Psychiatry Llc 10547 Montgomery Rd Ste 700 Montgomery OH 45242-4418 Ph: (888) 830-0347 | Mindfully Psychiatry Llc 10547 Montgomery Rd Ste 700 Montgomery OH 45242-4418 Ph: (513) 393-0300 |
| NPI Number | 1881341543 |
|---|---|
| Provider Enumeration Date | 03/03/2022 |
| Last Update Date | 05/19/2023 |
| Certification Date | 05/19/2023 |
| Medicare PECOS PAC ID | 3870961162 |
|---|---|
| Medicare Enrollment ID | O20221117000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881341543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kathie Jo Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457498495 PECOS PAC ID: 2860390457 Enrollment ID: I20031219000817 |
| Provider Name | Bipinchandra M Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720056484 PECOS PAC ID: 4486722246 Enrollment ID: I20081006000721 |
| Provider Name | Ann M Fulton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689822835 PECOS PAC ID: 4486706272 Enrollment ID: I20100927000941 |
| Provider Name | Cathleen A Mcknight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174830590 PECOS PAC ID: 1052508744 Enrollment ID: I20101207000859 |
| Provider Name | Pavan V Dontineni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790944866 PECOS PAC ID: 6507017720 Enrollment ID: I20121117000037 |
| Provider Name | Jonathan Cole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629350269 PECOS PAC ID: 6901112762 Enrollment ID: I20150825004442 |
| Provider Name | Teaera Roland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114468261 PECOS PAC ID: 1850666314 Enrollment ID: I20171009003443 |
| Provider Name | Jodie Lee Knodell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023248465 PECOS PAC ID: 1355711722 Enrollment ID: I20221228002946 |
| Provider Name | Carly Hamaoui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043913015 PECOS PAC ID: 8729445390 Enrollment ID: I20230613002535 |
| Provider Name | Tiffini Lasch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013650191 PECOS PAC ID: 5890154652 Enrollment ID: I20230711003645 |
| Provider Name | Miranda Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548946494 PECOS PAC ID: 5395180749 Enrollment ID: I20240226002271 |
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