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General NPI Number Information
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NPI Number | 1952292815
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Entity Type | Organization
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Legal Business Name | MOSAIC PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 37 IRON GATE PARK DR
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City | CENTERVILLE
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State | OH
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Zip | 45459-4616
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Country | US
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Telephone | 937-813-6240
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Fax | 937-619-8202
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Provider Business Mailing Address
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Address Line | 9125 PAYNE FARM LN
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City | WASHINGTON TOWNSHIP
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State | OH
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Zip | 45458-9393
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Country | US
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Telephone | 937-475-7759
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Fax | 937-619-8202
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KIMBERLY ANZEK
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Credential | PHD
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Telephone | 937-813-6240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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