| Authentic Practice Llc | |
|
66 West St Pittsfield MA 01201-5861 | |
| (612) 203-4285 | |
| Not Available |
| Full Name | Authentic Practice Llc |
|---|---|
| Speciality | Social Worker |
| Location | 66 West St, Pittsfield, Massachusetts |
| Authorized Official Name and Position | Bertel Mcelrath (OWNER) |
| Authorized Official Contact | 6122034285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Practice Llc 66 West St Pittsfield MA 01201-5861 Ph: (612) 203-4285 | Authentic Practice Llc 66 West St Pittsfield MA 01201-5861 Ph: (612) 203-4285 |
| NPI Number | 1508694605 |
|---|---|
| Provider Enumeration Date | 07/22/2024 |
| Last Update Date | 07/22/2024 |
| Certification Date | 07/22/2024 |
| Medicare PECOS PAC ID | 4486186434 |
|---|---|
| Medicare Enrollment ID | O20241015002248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508694605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Emily Marie Badger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447778691 PECOS PAC ID: 3678005626 Enrollment ID: I20241015002199 |
| Provider Name | Bertel Joseph Mcelrath |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134538101 PECOS PAC ID: 1658803606 Enrollment ID: I20241017002822 |
| Provider Name | Nicole Marie Stark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528320181 PECOS PAC ID: 3173846011 Enrollment ID: I20241021000876 |
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