| State Of Mind Counseling Services, Llc | |
|
619 Hammond Dr Milford DE 19963-2409 | |
| (302) 745-0628 | |
| Not Available |
| Full Name | State Of Mind Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 619 Hammond Dr, Milford, Delaware |
| Authorized Official Name and Position | Jessie L Howard (CO-OWNER) |
| Authorized Official Contact | 3027450628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Mind Counseling Services, Llc 619 Hammond Dr Milford DE 19963-2409 Ph: (302) 745-0628 | State Of Mind Counseling Services, Llc 619 Hammond Dr Milford DE 19963-2409 Ph: (302) 745-0628 |
| NPI Number | 1275260952 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 08/03/2022 |
| Certification Date | 08/03/2022 |
| Medicare PECOS PAC ID | 6901277706 |
|---|---|
| Medicare Enrollment ID | O20230113000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275260952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Lisa Lincoln |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972638005 PECOS PAC ID: 7618052283 Enrollment ID: I20210408000651 |
| Provider Name | Heather A Walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376936955 PECOS PAC ID: 8628469335 Enrollment ID: I20220106000509 |
| Provider Name | Stacey Meek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669108791 PECOS PAC ID: 1658745534 Enrollment ID: I20230315002323 |
| Provider Name | Renee Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669168373 PECOS PAC ID: 9931552791 Enrollment ID: I20240129000278 |
| Provider Name | Jessie Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578185815 PECOS PAC ID: 3274906193 Enrollment ID: I20240219000661 |
| Provider Name | Jessica Sullivan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639829955 PECOS PAC ID: 5395194575 Enrollment ID: I20240229000784 |
| Provider Name | Stephanie Boley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801425129 PECOS PAC ID: 5092188912 Enrollment ID: I20240229001285 |
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