MEDICARE: MENTAL SPACE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1295372225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL SPACE LLC

Provider Business Mailing Address
First Line	:	PO BOX 44163
Second Line	:
City	:	GOODFELLOW AFB
State	:	TX
Zip	:	76908-0163
Country	:	US
Telephone Number	:	706-619-1390
Fax Number	:	505-370-4730

Provider Business Practice Location Address
First Line	:	4408 COLUMBIA RD STE 104
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-4561
Country	:	US
Telephone Number	:	707-819-1390
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA STRINGFIELD
Credential	:
Telephone Number	:	706-619-1390

Provider Enumeration Date	:	12/10/2019
Last Update Date	:	11/18/2021

Similar Medicare Providers

1487328050 — MRS. CASSANDRE ELENA DUJOUR HUDSON LCSW
Practice Location Address:

4408 COLUMBIA RD STE 104
MARTINEZ, GA
30907-4561

Practice Phone: 706-310-5153
Practice Fax:

1487467395 — ANGISELIS LOURDES FELICIANO MARTELL
Practice Location Address:

4408 COLUMBIA RD STE 106
MARTINEZ, GA
30907-4561

Practice Phone: 984-220-6394
Practice Fax:

1871456756 — FENIXX IN FLOW
Practice Location Address:

4210 COLUMBIA RD STE 4A
MARTINEZ, GA
30907-0403

Practice Phone: 706-666-6984
Practice Fax:

1437784501 — MRS. ANGELA RENEE MCGAHA KERSEY MS, LPC, NCC
Practice Location Address:

4434 COLUMBIA RD STE 205
MARTINEZ, GA
30907-4281

Practice Phone: 706-910-0538
Practice Fax: 706-910-0537

1780547885 — SAKENNA CARTER
Practice Location Address:

4210 COLUMBIA RD BLDG 9
MARTINEZ, GA
30907-0401

Practice Phone: 706-842-5330
Practice Fax: 706-842-5340

1265434435 — AARON B COHRS PT
Practice Location Address:

3716B EXECUTIVE CENTER DR
MARTINEZ, GA
30907-2359

Practice Phone: 706-869-0505
Practice Fax: 706-869-0520

Directions to “MENTAL SPACE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.