| Bright Side Mood Therapy Llc | |
|
19 W Main St Ste 16 Ashland OH 44805-2220 | |
| (419) 281-2123 | |
| Not Available |
| Full Name | Bright Side Mood Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19 W Main St Ste 16, Ashland, Ohio |
| Authorized Official Name and Position | Heather Donnenwirth (OWNER) |
| Authorized Official Contact | 4192812123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Side Mood Therapy Llc 972 State Route 545 Ashland OH 44805-9710 Ph: (419) 281-2123 | Bright Side Mood Therapy Llc 19 W Main St Ste 16 Ashland OH 44805-2220 Ph: (419) 281-2123 |
| NPI Number | 1124675368 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 08/22/2019 |
| Medicare PECOS PAC ID | 2466860929 |
|---|---|
| Medicare Enrollment ID | O20210421002188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124675368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Heather Donnenwirth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851816649 PECOS PAC ID: 8921407107 Enrollment ID: I20210519002698 |
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