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General NPI Number Information
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NPI Number | 1598698896
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Entity Type | Organization
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Legal Business Name | MIND AND BRAIN CLINICAL SERVICES, LLC
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 2955 BROWNWOOD BLVD STE 100
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City | THE VILLAGES
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State | FL
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Zip | 32163-2040
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Country | US
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Telephone | 352-492-0156
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Fax |
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Provider Business Mailing Address
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Address Line | 532 RICHBURG ST
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City | THE VILLAGES
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State | FL
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Zip | 32162-6074
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Country | US
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Telephone | 352-492-0156
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. ROGER MILLER
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Credential | PH.D.
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Telephone | 352-492-0156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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