MEDICARE: PIECE OF MIND NEUROPSYCHOLOGY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	PY8438	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407365794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIECE OF MIND NEUROPSYCHOLOGY INC.

Provider Business Mailing Address
First Line	:	PO BOX 2933
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-0933
Country	:	US
Telephone Number	:	858-221-6311
Fax Number	:	888-388-2142

Provider Business Practice Location Address
First Line	:	3050 BROADWAY ST.
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3154
Country	:	US
Telephone Number	:	720-715-2212
Fax Number	:	888-314-8174

Authorized Official
Title or Position	:	CEO
Name	:	KAREN M MIKOLIC
Credential	:	PHD
Telephone Number	:	408-221-7990

Provider Enumeration Date	:	09/29/2017
Last Update Date	:	12/16/2025

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