Mind Works Therapy PLLC
Organization Active NPI Psychologist · Pass Christian, MS
NPI 1629601927 · NPPES record last updated Dec 3, 2024
Key facts
- NPI
- 1629601927
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- MIND WORKS THERAPY PLLC
- Practice address
- 213 Henderson Ave
Pass Christian, MS 39571-4309 - Phone
- (228) 300-8819
- Fax
- (601) 401-4289
- NPI assigned
- Feb 15, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Kristi W Mong, PHD
- Title
- Psychologist
- Phone
- (228) 563-4006
Practitioners 7
-
Julie M Forrest, LCSW
-
Brenda Gail Gilman, LPC
-
Christine Miller, LPC
-
Kristi Mong, PH.D.
-
Cynthia Helwig, NP
-
Vicki L Revell-Smith, MS,LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210112002973 | MS | Part B Supplier - Clinic/Group Practice | 8325451321 |
Receives reassigned benefits from 5 practitioners Practice locations: Pass Christian, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | Yes |
Addresses
Primary practice location
213 Henderson Ave
Pass Christian, MS 39571-4309
Mailing address
213 Henderson Ave
Pass Christian, MS 39571-4309
Phone (228) 300-8819
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009075709 | Medicaid | MS |
Other names
- Mind Works Psychologists
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | info@mindworkspsychologists.com |
Other providers in Pass Christian, MS
- Philip Albert McShane
- Memorial Hospital at Gulfport
- Rachel Louise Meredith
- Christine Miller
- Mind Repose LLC
- Mission Nutrition, L.L.C.
- Mississippi Dental Arts
- Mississippi Superior Senior Services
- Kristi Mong
- Michael Mong
All providers in Pass Christian, MS · Psychologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.