| Mynd Thera Pllc | |
|
19815 Mack Ave Ste B Grosse Pointe Woods MI 48236-2505 | |
| (313) 516-7143 | |
| Not Available |
| Full Name | Mynd Thera Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 19815 Mack Ave Ste B, Grosse Pointe Woods, Michigan |
| Authorized Official Name and Position | Nicholas Mischel (OWNER) |
| Authorized Official Contact | 3135167143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mynd Thera Pllc 19815 Mack Ave Ste B Grosse Pointe Woods MI 48236-2505 Ph: () - | Mynd Thera Pllc 19815 Mack Ave Ste B Grosse Pointe Woods MI 48236-2505 Ph: (313) 516-7143 |
| NPI Number | 1255146965 |
|---|---|
| Provider Enumeration Date | 02/10/2025 |
| Last Update Date | 02/10/2025 |
| Certification Date | 02/10/2025 |
| Medicare PECOS PAC ID | 2062937964 |
|---|---|
| Medicare Enrollment ID | O20250423000617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255146965 | NPI | - | NPPES |
| Provider Name | Bardia Gholami |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316079270 PECOS PAC ID: 5698903235 Enrollment ID: I20140106001083 |
| Provider Name | Nicholas Mischel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679968994 PECOS PAC ID: 2264761154 Enrollment ID: I20190830001689 |
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