| Thriving Minds LLC | |
|
15 Warren St Ste 23 Hackensack NJ 07601-5436 | |
| (201) 205-1131 | |
| (201) 258-7677 |
| Full Name | Thriving Minds LLC |
|---|---|
| Speciality | Social Worker |
| Location | 15 Warren St Ste 23, Hackensack, New Jersey |
| Authorized Official Name and Position | Jacqueline Powell (DIRECTOR) |
| Authorized Official Contact | 2013596253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriving Minds LLC 15 Warren St Ste 23 Hackensack NJ 07601-5436 Ph: (201) 205-1131 | Thriving Minds LLC 15 Warren St Ste 23 Hackensack NJ 07601-5436 Ph: (201) 205-1131 |
| NPI Number | 1316580293 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 04/24/2026 |
| Certification Date | 04/24/2026 |
| Medicare PECOS PAC ID | 1355812108 |
|---|---|
| Medicare Enrollment ID | O20260603000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316580293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Jacqueline Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730637893 PECOS PAC ID: 2264903012 Enrollment ID: I20260603000959 |
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