| Wise Mind Therapy & Counseling LLC | |
|
10 Higgins Hwy Ste 14 Mansfield Center CT 06250-1437 | |
| (860) 933-9937 | |
| (860) 228-8106 |
| Full Name | Wise Mind Therapy & Counseling LLC |
|---|---|
| Speciality | Counselor |
| Location | 10 Higgins Hwy Ste 14, Mansfield Center, Connecticut |
| Authorized Official Name and Position | Amanda Avery Risley (OWNER) |
| Authorized Official Contact | 8609333986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Mind Therapy & Counseling LLC 10 Higgins Hwy Ste 14 Mansfield Center CT 06250-1437 Ph: (860) 933-9937 | Wise Mind Therapy & Counseling LLC 10 Higgins Hwy Ste 14 Mansfield Center CT 06250-1437 Ph: (860) 933-9937 |
| NPI Number | 1972041267 |
|---|---|
| Provider Enumeration Date | 02/07/2017 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 1759822810 |
|---|---|
| Medicare Enrollment ID | O20240917003390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972041267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 003082 (Connecticut) | Primary |
| Provider Name | Amanda Risley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427475730 PECOS PAC ID: 5395286454 Enrollment ID: I20240917003586 |
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