| Eartheart Llc | |
|
4307 S Leonard Springs Rd Bloomington IN 47403-4078 | |
| (812) 345-2176 | |
| (206) 984-2440 |
| Full Name | Eartheart Llc |
|---|---|
| Speciality | Counselor |
| Location | 4307 S Leonard Springs Rd, Bloomington, Indiana |
| Authorized Official Name and Position | Bret Eartheart (TIN OWNER) |
| Authorized Official Contact | 8123452176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eartheart Llc 4307 S Leonard Springs Rd Bloomington IN 47403-4078 Ph: (812) 345-2176 | Eartheart Llc 4307 S Leonard Springs Rd Bloomington IN 47403-4078 Ph: (812) 345-2176 |
| NPI Number | 1720444813 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 11/29/2018 |
| Medicare PECOS PAC ID | 5597061390 |
|---|---|
| Medicare Enrollment ID | O20160303002178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720444813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Caitlin E Bryte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972882835 PECOS PAC ID: 8022271634 Enrollment ID: I20120518000004 |
| Provider Name | Bret D Eartheart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760788913 PECOS PAC ID: 3375761828 Enrollment ID: I20140826001467 |
| Provider Name | Audra Nicole Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770165763 PECOS PAC ID: 9335558220 Enrollment ID: I20210505001456 |
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