| Bustamante Counseling | |
|
317 W Hill St Ste 203b Decatur GA 30030-4368 | |
| (470) 991-1619 | |
| Not Available |
| Full Name | Bustamante Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 317 W Hill St Ste 203b, Decatur, Georgia |
| Authorized Official Name and Position | Lindsey Bustamante (OWNER) |
| Authorized Official Contact | 4709911619 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bustamante Counseling 5235 Deerlake Dr Alpharetta GA 30005-3604 Ph: (470) 991-1619 | Bustamante Counseling 317 W Hill St Ste 203b Decatur GA 30030-4368 Ph: (470) 991-1619 |
| NPI Number | 1073127056 |
|---|---|
| Provider Enumeration Date | 09/07/2020 |
| Last Update Date | 09/07/2020 |
| Certification Date | 09/07/2020 |
| Medicare PECOS PAC ID | 2466865373 |
|---|---|
| Medicare Enrollment ID | O20210114002019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073127056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lindsey C Bustamante |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336471499 PECOS PAC ID: 1658680624 Enrollment ID: I20151014003077 |
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