Free Your Mind Therapy LLC
NPI 1154001469ActiveOrganization· Social Worker, Clinical· Bolivar, MO
Social Worker, Clinical in Bolivar, Missouri, registered in NPPES in July 2023. The authorized official on file is Kimberly A. Robertson, LCSW, Founder/Managing Member. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1154001469 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 20, 2023 |
| Last updated in NPPES | Apr 4, 2026 |
| Certified by provider | Apr 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (MO) |
|---|
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