Healthcare Provider Details

I. General information

NPI: 1407365794
Provider Name (Legal Business Name): PIECE OF MIND NEUROPSYCHOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 BROADWAY ST.
BOULDER CO
80304-3154
US

IV. Provider business mailing address

PO BOX 2933
SUNNYVALE CA
94087-0933
US

V. Phone/Fax

Practice location:
  • Phone: 720-715-2212
  • Fax: 888-314-8174
Mailing address:
  • Phone: 858-221-6311
  • Fax: 888-388-2142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY8438
License Number StateFL

VIII. Authorized Official

Name: KAREN M MIKOLIC
Title or Position: CEO
Credential: PHD
Phone: 408-221-7990