• Request a Callback

    Let us know how we can help you!
  • Format: (000) 000-0000.
  • Do you plan to use insurance?*

  • We accept the following insurance plans:

    • Aetna
    • Aetna Better Health
    • Anthem / Blue Cross Blue Shield (Commercial, Medicare & Medicaid)
    • Cigna (Virginia plans only)
    • Medicaid
    • Medicare
    • Neighborhood Health Plan of Rhode Island (NHPRI)
    • Sentara Health Plans
    • Tufts Health Plan
    • Harvard Pilgrim Health Care
    • UnitedHealthcare (Commercial plans only)


    *Insurance coverage is subject to verification of eligibility and benefits*

  • What services are you interested in?*
  • What time of day is best to contact you?*

  • Terms & Conditions – Request to be Contacted


    By submitting this form, you acknowledge and agree that:

    • This form is a request to be contacted and does not establish a provider–patient relationship.

    • By providing your contact information, you authorize Eccentric Minds Health & Wellness PLLC to contact you by phone, text, or email regarding your inquiry.

    • If this request is for a minor, a parent or legal guardian must participate in scheduling.

  • Should be Empty: