| Constellate Patchwork Therapy & Consulting | |
|
85 2nd St California PA 15419-1018 | |
| (814) 758-0442 | |
| Not Available |
| Full Name | Constellate Patchwork Therapy & Consulting |
|---|---|
| Speciality | Social Worker |
| Location | 85 2nd St, California, Pennsylvania |
| Authorized Official Name and Position | Jessica Storm (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8147580442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Constellate Patchwork Therapy & Consulting 85 2nd St California PA 15419-1018 Ph: (814) 758-0442 | Constellate Patchwork Therapy & Consulting 85 2nd St California PA 15419-1018 Ph: (814) 758-0442 |
| NPI Number | 1235819483 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 07/21/2023 |
| Certification Date | 07/21/2023 |
| Medicare PECOS PAC ID | 9335597046 |
|---|---|
| Medicare Enrollment ID | O20231117002989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235819483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Storm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205586880 PECOS PAC ID: 0244688950 Enrollment ID: I20231117003058 |
Enlightened Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 419 Wood St, California, PA 15419 Phone: 724-715-3700 |