| Brainpathway, Llc | |
|
2809 N Broadway St Ste 1 Pittsburg KS 66762-2698 | |
| (620) 249-3539 | |
| Not Available |
| Full Name | Brainpathway, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2809 N Broadway St Ste 1, Pittsburg, Kansas |
| Authorized Official Name and Position | Charrisa Castillo (OWNER) |
| Authorized Official Contact | 6202493539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainpathway, Llc 2809 N Broadway St Ste 1 Pittsburg KS 66762-2698 Ph: (620) 249-3539 | Brainpathway, Llc 2809 N Broadway St Ste 1 Pittsburg KS 66762-2698 Ph: (620) 249-3539 |
| NPI Number | 1417656638 |
|---|---|
| Provider Enumeration Date | 02/27/2023 |
| Last Update Date | 02/27/2023 |
| Certification Date | 02/27/2023 |
| Medicare PECOS PAC ID | 2264805456 |
|---|---|
| Medicare Enrollment ID | O20230309001510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417656638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Charrisa D Castillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881990208 PECOS PAC ID: 7911218227 Enrollment ID: I20150612000487 |
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