Provider Demographics
NPI:1336654235
Name:MINDWORKS ASSESSMENT
Entity Type:Organization
Organization Name:MINDWORKS ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GETTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-559-0909
Mailing Address - Street 1:3301 N PERRY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-5237
Mailing Address - Country:US
Mailing Address - Phone:813-956-9213
Mailing Address - Fax:
Practice Address - Street 1:15961 N FLORIDA AVE STE C
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-8101
Practice Address - Country:US
Practice Address - Phone:813-559-0909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS810261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)