| A Space For Us Counseling | |
|
11 W Ormond Ave Ste 100a Cherry Hill NJ 08002-3051 | |
| (609) 920-3848 | |
| Not Available |
| Full Name | A Space For Us Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 11 W Ormond Ave Ste 100a, Cherry Hill, New Jersey |
| Authorized Official Name and Position | Keana Reed (OWNER) |
| Authorized Official Contact | 6099203848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Space For Us Counseling 914 Edgemoor Rd Cherry Hill NJ 08034-3940 Ph: (609) 920-3848 | A Space For Us Counseling 11 W Ormond Ave Ste 100a Cherry Hill NJ 08002-3051 Ph: (609) 920-3848 |
| NPI Number | 1497467708 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 04/07/2023 |
| Certification Date | 04/07/2023 |
| Medicare PECOS PAC ID | 0749655157 |
|---|---|
| Medicare Enrollment ID | O20230417000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497467708 | NPI | - | NPPES |
| Provider Name | Keana Fairfax |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588376891 PECOS PAC ID: 1658746060 Enrollment ID: I20230417000625 |
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