| Mindful Np Psychiatry Pllc | |
|
5 Laura Rd Monroe NY 10950-5206 | |
| (845) 659-4508 | |
| Not Available |
| Full Name | Mindful Np Psychiatry Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 5 Laura Rd, Monroe, New York |
| Authorized Official Name and Position | Cassandra Fortune (OWNER) |
| Authorized Official Contact | 8456594508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Np Psychiatry Pllc 5 Laura Rd Monroe NY 10950-5206 Ph: () - | Mindful Np Psychiatry Pllc 5 Laura Rd Monroe NY 10950-5206 Ph: (845) 659-4508 |
| NPI Number | 1558178764 |
|---|---|
| Provider Enumeration Date | 12/12/2024 |
| Last Update Date | 12/12/2024 |
| Medicare PECOS PAC ID | 8820527849 |
|---|---|
| Medicare Enrollment ID | O20250121001617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558178764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Cassandra Fortune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205230182 PECOS PAC ID: 5991237687 Enrollment ID: I20241018003422 |
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