| Destiny Supportive Services | |
|
563 High St Ste B Burlington NJ 08016-4592 | |
| (856) 912-0712 | |
| Not Available |
| Full Name | Destiny Supportive Services |
|---|---|
| Speciality | Social Worker |
| Location | 563 High St Ste B, Burlington, New Jersey |
| Authorized Official Name and Position | Noni Kendall (OWNER) |
| Authorized Official Contact | 8569120712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Supportive Services 563 High St Ste B Burlington NJ 08016-4592 Ph: (856) 912-0712 | Destiny Supportive Services 563 High St Ste B Burlington NJ 08016-4592 Ph: (856) 912-0712 |
| NPI Number | 1811672322 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 06/21/2023 |
| Certification Date | 06/21/2023 |
| Medicare PECOS PAC ID | 4789048174 |
|---|---|
| Medicare Enrollment ID | O20230919001526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811672322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Noni Kendall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538663695 PECOS PAC ID: 6901260397 Enrollment ID: I20230919002418 |
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