| Mindme Llc | |
|
10163 Fortune Pkwy Jacksonville FL 32256-3519 | |
| (904) 299-5387 | |
| (833) 624-1727 |
| Full Name | Mindme Llc |
|---|---|
| Speciality | Counselor |
| Location | 10163 Fortune Pkwy, Jacksonville, Florida |
| Authorized Official Name and Position | Angela Whittinghill (OWNER) |
| Authorized Official Contact | 9045714102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindme Llc 1523 Oak Lace Ct Jacksonville FL 32225-2847 Ph: (904) 571-4102 | Mindme Llc 10163 Fortune Pkwy Jacksonville FL 32256-3519 Ph: (904) 299-5387 |
| NPI Number | 1518670652 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Medicare PECOS PAC ID | 7315475258 |
|---|---|
| Medicare Enrollment ID | O20250106003595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518670652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Angela M Whittinghill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376054809 PECOS PAC ID: 7517373889 Enrollment ID: I20250106003628 |
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