| Cultivating Liberation Counseling Llc | |
|
7808 Stefenoni Ct Unit B Sebastopol CA 95472-3535 | |
| (707) 666-5170 | |
| Not Available |
| Full Name | Cultivating Liberation Counseling Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7808 Stefenoni Ct Unit B, Sebastopol, California |
| Authorized Official Name and Position | Joy Jaco (SUPERVISOR) |
| Authorized Official Contact | 7076665170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cultivating Liberation Counseling Llc Po Box 910 Sebastopol CA 95473-0910 Ph: (707) 666-5170 | Cultivating Liberation Counseling Llc 7808 Stefenoni Ct Unit B Sebastopol CA 95472-3535 Ph: (707) 666-5170 |
| NPI Number | 1194571711 |
|---|---|
| Provider Enumeration Date | 04/25/2024 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/24/2024 |
| Medicare PECOS PAC ID | 5294270930 |
|---|---|
| Medicare Enrollment ID | O20240717002576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194571711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Joy Diane Jaco |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811506678 PECOS PAC ID: 7911442652 Enrollment ID: I20240717002747 |
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