| Moving Mindful Therapy Llc | |
|
241 Blanche Circle Rock Hill SC 29730 | |
| (252) 373-6280 | |
| Not Available |
| Full Name | Moving Mindful Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 241 Blanche Circle, Rock Hill, South Carolina |
| Authorized Official Name and Position | Niesha Gowens (OWNER/ THERAPIST) |
| Authorized Official Contact | 2523736280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moving Mindful Therapy Llc 241 Blanche Cir Rock Hill SC 29730-4905 Ph: (252) 373-6280 | Moving Mindful Therapy Llc 241 Blanche Circle Rock Hill SC 29730 Ph: (252) 373-6280 |
| NPI Number | 1316711526 |
|---|---|
| Provider Enumeration Date | 11/08/2023 |
| Last Update Date | 11/08/2023 |
| Certification Date | 11/08/2023 |
| Medicare PECOS PAC ID | 4385171149 |
|---|---|
| Medicare Enrollment ID | O20241218002840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316711526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Niesha Gowens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972172682 PECOS PAC ID: 5294262051 Enrollment ID: I20241218003330 |
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