| Mothermind Psychology | |
|
19105 N Us Highway 41 Ste 300 Lutz FL 33549-4206 | |
| (813) 400-0375 | |
| (813) 616-6818 |
| Full Name | Mothermind Psychology |
|---|---|
| Speciality | Psychologist |
| Location | 19105 N Us Highway 41 Ste 300, Lutz, Florida |
| Authorized Official Name and Position | Patricia Henandez Poudevida (OWNER/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8134000375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mothermind Psychology 19105 N Us Highway 41 Ste 300 Lutz FL 33549-4206 Ph: (813) 400-0375 | Mothermind Psychology 19105 N Us Highway 41 Ste 300 Lutz FL 33549-4206 Ph: (813) 400-0375 |
| NPI Number | 1992323778 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 04/28/2022 |
| Certification Date | 04/28/2022 |
| Medicare PECOS PAC ID | 3476907536 |
|---|---|
| Medicare Enrollment ID | O20230925000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992323778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia Hernandez Poudevida |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740420405 PECOS PAC ID: 0840644902 Enrollment ID: I20230925000836 |
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