| Paulenich Mental Health Pllc | |
|
2413 Main St Ste 204 Ferndale WA 98248-8827 | |
| (360) 296-3989 | |
| Not Available |
| Full Name | Paulenich Mental Health Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2413 Main St Ste 204, Ferndale, Washington |
| Authorized Official Name and Position | Ariel Paulenich (OWNER) |
| Authorized Official Contact | 3602963989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paulenich Mental Health Pllc Po Box 3134 Ferndale WA 98248-3134 Ph: (360) 296-3989 | Paulenich Mental Health Pllc 2413 Main St Ste 204 Ferndale WA 98248-8827 Ph: (360) 296-3989 |
| NPI Number | 1972160265 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 08/24/2023 |
| Certification Date | 08/24/2023 |
| Medicare PECOS PAC ID | 5395074645 |
|---|---|
| Medicare Enrollment ID | O20190911002170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972160265 | NPI | - | NPPES |
| 2072909 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Ariel Paulenich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114462645 PECOS PAC ID: 2062796337 Enrollment ID: I20170306000616 |
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