| Authentic Connections Counseling | |
|
455 Sea St Unit 1b Quincy MA 02169-2704 | |
| (508) 494-2357 | |
| Not Available |
| Full Name | Authentic Connections Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 455 Sea St Unit 1b, Quincy, Massachusetts |
| Authorized Official Name and Position | Sally A Kiss (PRESIDENT) |
| Authorized Official Contact | 5084942357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Connections Counseling 455 Sea St Unit 1b Quincy MA 02169-2704 Ph: (508) 494-2357 | Authentic Connections Counseling 455 Sea St Unit 1b Quincy MA 02169-2704 Ph: (508) 494-2357 |
| NPI Number | 1093406951 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 05/19/2023 |
| Certification Date | 05/19/2023 |
| Medicare PECOS PAC ID | 3274067442 |
|---|---|
| Medicare Enrollment ID | O20241111001278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093406951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Aleshia Marie Ellingson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528318615 PECOS PAC ID: 6709278096 Enrollment ID: I20220118002528 |
| Provider Name | Sally Ann Kiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235515883 PECOS PAC ID: 7012346794 Enrollment ID: I20241113000041 |
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