| Authentic Healing Llc | |
|
2701 International Ln Ste 205 Madison WI 53704-3126 | |
| (608) 390-3535 | |
| (608) 390-3535 |
| Full Name | Authentic Healing Llc |
|---|---|
| Speciality | Counselor |
| Location | 2701 International Ln Ste 205, Madison, Wisconsin |
| Authorized Official Name and Position | Leah Mary Thompson (OWNER) |
| Authorized Official Contact | 6085132407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Healing Llc 2701 International Ln Ste 205 Madison WI 53704-3126 Ph: (608) 390-3535 | Authentic Healing Llc 2701 International Ln Ste 205 Madison WI 53704-3126 Ph: (608) 390-3535 |
| NPI Number | 1912521188 |
|---|---|
| Provider Enumeration Date | 06/03/2020 |
| Last Update Date | 06/15/2022 |
| Certification Date | 06/15/2022 |
| Medicare PECOS PAC ID | 2860811296 |
|---|---|
| Medicare Enrollment ID | O20201002002341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912521188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Emily J Krause |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891089702 PECOS PAC ID: 7618107756 Enrollment ID: I20140311000746 |
| Provider Name | Heather Edge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700192135 PECOS PAC ID: 0244453835 Enrollment ID: I20140529001533 |
| Provider Name | Leah M Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982982559 PECOS PAC ID: 0345669099 Enrollment ID: I20240207002946 |
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