| Dancing Thistle Llc | |
|
197 Palmer Ave Falmouth MA 02540-2806 | |
| (508) 933-2246 | |
| Not Available |
| Full Name | Dancing Thistle Llc |
|---|---|
| Speciality | Counselor |
| Location | 197 Palmer Ave, Falmouth, Massachusetts |
| Authorized Official Name and Position | Dea Elizabeth Butcher (SOLE MEMBER) |
| Authorized Official Contact | 5099332246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dancing Thistle Llc 22 Sand Point Shores Dr East Falmouth MA 02536-4739 Ph: (508) 933-2246 | Dancing Thistle Llc 197 Palmer Ave Falmouth MA 02540-2806 Ph: (508) 933-2246 |
| NPI Number | 1386274306 |
|---|---|
| Provider Enumeration Date | 01/17/2020 |
| Last Update Date | 01/17/2020 |
| Certification Date | 01/17/2020 |
| Medicare PECOS PAC ID | 7911343652 |
|---|---|
| Medicare Enrollment ID | O20240315002273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386274306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dea Elizabeth Butcher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487957510 PECOS PAC ID: 8325481377 Enrollment ID: I20240207001658 |
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