| Mind Manifesting Counseling | |
|
12360 66th St Ste H4 Largo FL 33773-3434 | |
| (832) 740-8769 | |
| Not Available |
| Full Name | Mind Manifesting Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 12360 66th St Ste H4, Largo, Florida |
| Authorized Official Name and Position | Travis Atchison (OWNER) |
| Authorized Official Contact | 8327408769 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Manifesting Counseling 2320 Williams Dr Largo FL 33778-1242 Ph: (832) 740-8769 | Mind Manifesting Counseling 12360 66th St Ste H4 Largo FL 33773-3434 Ph: (832) 740-8769 |
| NPI Number | 1841178977 |
|---|---|
| Provider Enumeration Date | 08/26/2025 |
| Last Update Date | 12/02/2025 |
| Certification Date | 12/02/2025 |
| Medicare PECOS PAC ID | 3971089533 |
|---|---|
| Medicare Enrollment ID | O20260113003714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841178977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Travis Benjamin Atchison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124628169 PECOS PAC ID: 4385014315 Enrollment ID: I20230106002740 |
| Provider Name | Dharti Atchison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669147229 PECOS PAC ID: 6002288107 Enrollment ID: I20230220001288 |
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