| Blue Creek Psychotherapy Llc | |
|
900 Heritage Dr Ste 910 Pottstown PA 19464-9223 | |
| (484) 433-2025 | |
| Not Available |
| Full Name | Blue Creek Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 900 Heritage Dr Ste 910, Pottstown, Pennsylvania |
| Authorized Official Name and Position | Mark Merryman (CO-OWNER) |
| Authorized Official Contact | 4844332025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Creek Psychotherapy Llc 117 Cobblestone Dr Gilbertsville PA 19525-8844 Ph: (484) 433-2025 | Blue Creek Psychotherapy Llc 900 Heritage Dr Ste 910 Pottstown PA 19464-9223 Ph: (484) 433-2025 |
| NPI Number | 1801454129 |
|---|---|
| Provider Enumeration Date | 06/01/2019 |
| Last Update Date | 06/01/2019 |
| Medicare PECOS PAC ID | 0446581771 |
|---|---|
| Medicare Enrollment ID | O20191017000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801454129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mark A Merryman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932341468 PECOS PAC ID: 6608046313 Enrollment ID: I20110906000605 |
| Provider Name | Anna C Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083978001 PECOS PAC ID: 1557517810 Enrollment ID: I20120802000320 |
| Provider Name | Erica L Avello |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417346560 PECOS PAC ID: 3971810383 Enrollment ID: I20150917001749 |
| Provider Name | Christina Hallquist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831438589 PECOS PAC ID: 8224345558 Enrollment ID: I20150917002589 |
| Provider Name | Rachael Kathryn Keyser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295409365 PECOS PAC ID: 6608220819 Enrollment ID: I20230921002517 |
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