| Minds and Motion Wellness LLC | |
|
67 Federal Rd Building A, Suite 201 Brookfield CT 06804-0680 | |
| (860) 317-6005 | |
| Not Available |
| Full Name | Minds and Motion Wellness LLC |
|---|---|
| Speciality | Counselor |
| Location | 67 Federal Rd, Brookfield, Connecticut |
| Authorized Official Name and Position | Danielle Dipisa (OWNER) |
| Authorized Official Contact | 8603176005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minds and Motion Wellness LLC 67 Federal Rd Building A, Suite 201 Brookfield CT 06804 Ph: (860) 317-6005 | Minds and Motion Wellness LLC 67 Federal Rd Building A, Suite 201 Brookfield CT 06804-0680 Ph: (860) 317-6005 |
| NPI Number | 1376429589 |
|---|---|
| Provider Enumeration Date | 08/13/2025 |
| Last Update Date | 08/13/2025 |
| Certification Date | 08/13/2025 |
| Medicare PECOS PAC ID | 8022500891 |
|---|---|
| Medicare Enrollment ID | O20251120000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376429589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Secondary |
| Provider Name | Danielle Dipisa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245707199 PECOS PAC ID: 9739671504 Enrollment ID: I20251120000654 |
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