| Open Mind Counseling, Llc | |
|
100 W 3rd St Ste 304 Owensboro KY 42303-4129 | |
| (812) 719-4633 | |
| Not Available |
| Full Name | Open Mind Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 100 W 3rd St Ste 304, Owensboro, Kentucky |
| Authorized Official Name and Position | Stephanie M Decker (MENTAL HEALTH COUNSELOR/ OWNER) |
| Authorized Official Contact | 8127194633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Mind Counseling, Llc 100 W 3rd St Ste 304 Owensboro KY 42303-4129 Ph: (812) 719-4633 | Open Mind Counseling, Llc 100 W 3rd St Ste 304 Owensboro KY 42303-4129 Ph: (812) 719-4633 |
| NPI Number | 1669024188 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 10/07/2020 |
| Certification Date | 10/07/2020 |
| Medicare PECOS PAC ID | 1658707591 |
|---|---|
| Medicare Enrollment ID | O20200212001360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669024188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie M Decker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932530029 PECOS PAC ID: 6507158235 Enrollment ID: I20160715001700 |
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