| Awakened Heart Llc | |
|
456 Sw Washington Ave Corvallis OR 97333-4405 | |
| (541) 368-8324 | |
| (833) 559-1051 |
| Full Name | Awakened Heart Llc |
|---|---|
| Speciality | Counselor |
| Location | 456 Sw Washington Ave, Corvallis, Oregon |
| Authorized Official Name and Position | Tove Gilbert-morgan (OWNER) |
| Authorized Official Contact | 5413688324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awakened Heart Llc 456 Sw Washington Ave Corvallis OR 97333-4405 Ph: (541) 368-8324 | Awakened Heart Llc 456 Sw Washington Ave Corvallis OR 97333-4405 Ph: (541) 368-8324 |
| NPI Number | 1992413900 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 11/08/2022 |
| Certification Date | 11/08/2022 |
| Medicare PECOS PAC ID | 9133564750 |
|---|---|
| Medicare Enrollment ID | O20240305001368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992413900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tove Gilbert-morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962861013 PECOS PAC ID: 0042655664 Enrollment ID: I20240305001499 |
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