| Mindscapes, Llc | |
|
1241 Hill Rd N Pickerington OH 43147-7989 | |
| (614) 604-6067 | |
| (614) 604-6529 |
| Full Name | Mindscapes, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1241 Hill Rd N, Pickerington, Ohio |
| Authorized Official Name and Position | Angela S Coleman (OFFICE MANAGER) |
| Authorized Official Contact | 6146046067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindscapes, Llc 1241 Hill Rd N Pickerington OH 43147-7989 Ph: (614) 604-6067 | Mindscapes, Llc 1241 Hill Rd N Pickerington OH 43147-7989 Ph: (614) 604-6067 |
| NPI Number | 1174161640 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 07/03/2020 |
| Certification Date | 07/03/2020 |
| Medicare PECOS PAC ID | 1052733094 |
|---|---|
| Medicare Enrollment ID | O20200622001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174161640 | NPI | - | NPPES |
| 0380208 | Medicaid | OH | |
| 1023631447 | Other | OH | OTPTAT BOARD |
| 1659703676 | Other | OH | PSYCHOLOGY BOARD |
| 1063972362 | Other | OH | SPEECH AND HEARING PROFESSIONALS BOARD |
| 1720497217 | Other | OH | SPEECH AND HEARING PROFESSIONALS BOARD |
| 1851925465 | Other | OH | COTA/L |
| Provider Name | Kelli Sears |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659703676 PECOS PAC ID: 7012345663 Enrollment ID: I20200623001091 |
| Provider Name | Olivia Tennison |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1063972362 PECOS PAC ID: 1759703648 Enrollment ID: I20200623001236 |
| Provider Name | Kailey Mcdaniel |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023631447 PECOS PAC ID: 0941622849 Enrollment ID: I20200623001521 |
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