| Blended Pathways Therapy, Pllc | |
|
2520 S Washington St Unit C Grand Forks ND 58201-6777 | |
| (970) 397-7929 | |
| Not Available |
| Full Name | Blended Pathways Therapy, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2520 S Washington St Unit C, Grand Forks, North Dakota |
| Authorized Official Name and Position | Elizabeth Meyer (OWNER) |
| Authorized Official Contact | 9703977929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blended Pathways Therapy, Pllc 2520 S Washington St Unit C Grand Forks ND 58201-6777 Ph: (970) 397-7929 | Blended Pathways Therapy, Pllc 2520 S Washington St Unit C Grand Forks ND 58201-6777 Ph: (970) 397-7929 |
| NPI Number | 1528827177 |
|---|---|
| Provider Enumeration Date | 03/18/2024 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/16/2024 |
| Medicare PECOS PAC ID | 5496194672 |
|---|---|
| Medicare Enrollment ID | O20240420000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528827177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770148371 PECOS PAC ID: 9335580596 Enrollment ID: I20240519000028 |
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