| Broken Angel Counseling Pllc | |
|
2208 Us Highway 421 N Boone NC 28607-7692 | |
| (724) 968-2435 | |
| Not Available |
| Full Name | Broken Angel Counseling Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2208 Us Highway 421 N, Boone, North Carolina |
| Authorized Official Name and Position | Emily Jane Capps (OWNER/THERAPIST) |
| Authorized Official Contact | 7249682435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Angel Counseling Pllc 2208 Us Highway 421 N Boone NC 28607-7692 Ph: () - | Broken Angel Counseling Pllc 2208 Us Highway 421 N Boone NC 28607-7692 Ph: (724) 968-2435 |
| NPI Number | 1053151589 |
|---|---|
| Provider Enumeration Date | 05/31/2024 |
| Last Update Date | 05/31/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 3375089071 |
|---|---|
| Medicare Enrollment ID | O20240904000497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053151589 | NPI | - | NPPES |
| Provider Name | Emily Jane Capps |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003189101 PECOS PAC ID: 4284170986 Enrollment ID: I20240904000762 |
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