| Alex Eaton Psychological Services, Pllc | |
|
1705 4th Ave Nw Minot ND 58703-2912 | |
| (701) 839-0474 | |
| Not Available |
| Full Name | Alex Eaton Psychological Services, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1705 4th Ave Nw, Minot, North Dakota |
| Authorized Official Name and Position | Alex Keith Eaton (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7018390474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alex Eaton Psychological Services, Pllc 1705 4th Ave Nw Minot ND 58703-2912 Ph: (701) 839-0474 | Alex Eaton Psychological Services, Pllc 1705 4th Ave Nw Minot ND 58703-2912 Ph: (701) 839-0474 |
| NPI Number | 1003581273 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 08/10/2021 |
| Certification Date | 08/10/2021 |
| Medicare PECOS PAC ID | 1254738636 |
|---|---|
| Medicare Enrollment ID | O20210928001663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003581273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Alex Keith Eaton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982261368 PECOS PAC ID: 2163829540 Enrollment ID: I20210928002111 |
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