| Themindfullcup, Llc | |
|
2 Corporate Dr Ste 950 Shelton CT 06484-6246 | |
| (860) 264-5565 | |
| (888) 220-8727 |
| Full Name | Themindfullcup, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2 Corporate Dr Ste 950, Shelton, Connecticut |
| Authorized Official Name and Position | Jennifer Demayo (OWNER & PSYCHOTHERAPIST) |
| Authorized Official Contact | 8602645565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Themindfullcup, Llc 1204 Main St # 772 Branford CT 06405-3787 Ph: (860) 264-5565 | Themindfullcup, Llc 2 Corporate Dr Ste 950 Shelton CT 06484-6246 Ph: (860) 264-5565 |
| NPI Number | 1811509730 |
|---|---|
| Provider Enumeration Date | 08/21/2020 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Medicare PECOS PAC ID | 7517301070 |
|---|---|
| Medicare Enrollment ID | O20240223000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811509730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jennifer Demayo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184179798 PECOS PAC ID: 9335583897 Enrollment ID: I20240223000598 |
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