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General NPI Number Information
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NPI Number | 1255059978
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Entity Type | Organization
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Legal Business Name | MOSAIC MINDS COUNSELING, LLC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 433 PLAZA REAL STE 275
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City | BOCA RATON
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State | FL
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Zip | 33432-3999
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Country | US
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Telephone | 904-467-4668
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BUSCH DR UNIT 77171
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City | JACKSONVILLE
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State | FL
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Zip | 32226-7783
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Country | US
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Telephone | 904-467-4668
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ZACHARY BELL
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Credential |
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Telephone | 904-467-4668
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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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