| Blue Ridge Counseling Services, Llc | |
|
401 E Louther St Ste 204 Carlisle PA 17013-2646 | |
| (717) 918-9961 | |
| (717) 918-9961 |
| Full Name | Blue Ridge Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 401 E Louther St Ste 204, Carlisle, Pennsylvania |
| Authorized Official Name and Position | Emily Fenner (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7179189961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Counseling Services, Llc 401 E Louther St Ste 204 Carlisle PA 17013-2646 Ph: (717) 918-9961 | Blue Ridge Counseling Services, Llc 401 E Louther St Ste 204 Carlisle PA 17013-2646 Ph: (717) 918-9961 |
| NPI Number | 1841941671 |
|---|---|
| Provider Enumeration Date | 01/13/2022 |
| Last Update Date | 01/13/2022 |
| Certification Date | 01/13/2022 |
| Medicare PECOS PAC ID | 9638561491 |
|---|---|
| Medicare Enrollment ID | O20220128000372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841941671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Emily Carolyn Fenner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114686706 PECOS PAC ID: 0547652307 Enrollment ID: I20220128000426 |
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