Adam Harrison, Licensed Clinical Social Worker Inc. | |
1401 21st St Ste R Sacramento CA 95811-5226 | |
(925) 217-0485 | |
Not Available |
Full Name | Adam Harrison, Licensed Clinical Social Worker Inc. |
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Speciality | Clinic/Center |
Location | 1401 21st St Ste R, Sacramento, California |
Authorized Official Name and Position | Adam Harrison (OWNER) |
Authorized Official Contact | 9252170485 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Adam Harrison, Licensed Clinical Social Worker Inc. Po Box 5533 Walnut Creek CA 94596-1533 Ph: () - | Adam Harrison, Licensed Clinical Social Worker Inc. 1401 21st St Ste R Sacramento CA 95811-5226 Ph: (925) 217-0485 |
NPI Number | 1225764491 |
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Provider Enumeration Date | 07/28/2022 |
Last Update Date | 07/28/2022 |
Certification Date | 07/28/2022 |
Medicare PECOS PAC ID | 7618352402 |
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Medicare Enrollment ID | O20220914002975 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225764491 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Adam Tyler Harrison |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1558642736 PECOS PAC ID: 5395025282 Enrollment ID: I20220914003026 |
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