| Mindwise Counseling | |
|
4005 Highway 101 Ste 1 Florence OR 97439-7804 | |
| (541) 991-9585 | |
| Not Available |
| Full Name | Mindwise Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 4005 Highway 101 Ste 1, Florence, Oregon |
| Authorized Official Name and Position | Jennifer Louise Speakman (CO-OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 5419919585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindwise Counseling 4005 Highway 101 Ste 1 Florence OR 97439-7804 Ph: (541) 991-9585 | Mindwise Counseling 4005 Highway 101 Ste 1 Florence OR 97439-7804 Ph: (541) 991-9585 |
| NPI Number | 1134685456 |
|---|---|
| Provider Enumeration Date | 02/11/2019 |
| Last Update Date | 02/11/2019 |
| Medicare PECOS PAC ID | 7911232921 |
|---|---|
| Medicare Enrollment ID | O20190712002748 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134685456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Speakman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023435591 PECOS PAC ID: 8820382898 Enrollment ID: I20160815000738 |
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