| Beacon Therapeutic And Wellness Services | |
|
3201 Yorktown Ave Ste 117e Durham NC 27713-1474 | |
| (919) 627-0987 | |
| Not Available |
| Full Name | Beacon Therapeutic And Wellness Services |
|---|---|
| Speciality | Social Worker |
| Location | 3201 Yorktown Ave Ste 117e, Durham, North Carolina |
| Authorized Official Name and Position | Tara Meredith Escalante (OWNER) |
| Authorized Official Contact | 9196270987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Therapeutic And Wellness Services 2900 Arnold Rd Durham NC 27707-2852 Ph: (919) 627-0987 | Beacon Therapeutic And Wellness Services 3201 Yorktown Ave Ste 117e Durham NC 27713-1474 Ph: (919) 627-0987 |
| NPI Number | 1912546573 |
|---|---|
| Provider Enumeration Date | 12/31/2019 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 8729430699 |
|---|---|
| Medicare Enrollment ID | O20240116002969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912546573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tara Meredith Escalante |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871844308 PECOS PAC ID: 9335451863 Enrollment ID: I20240116003118 |
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