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General NPI Number Information
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NPI Number | 1083568943
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Entity Type | Organization
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Legal Business Name | OUR MOSAIC MIND MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 2810 N CHURCH ST PMB 288471
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City | WILMINGTON
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State | DE
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Zip | 19802-4447
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Country | US
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Telephone | 703-705-2457
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Fax |
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Provider Business Mailing Address
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Address Line | 2810 N CHURCH ST
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City | WILMINGTON
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State | DE
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Zip | 19802-4447
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/FOUNDER
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Name | KRYSTA MICHAELIDES
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Credential | LMHC, LPC, LCPC
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Telephone | 703-705-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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