| Emotional And Behavioral Therapy | |
|
915 Eagle View Dr Kodak TN 37764-2418 | |
| (865) 280-2123 | |
| (561) 634-2874 |
| Full Name | Emotional And Behavioral Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 915 Eagle View Dr, Kodak, Tennessee |
| Authorized Official Name and Position | Claudia Hirsemann (OWNER/OPERATOR) |
| Authorized Official Contact | 8652802123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional And Behavioral Therapy 915 Eagle View Dr Kodak TN 37764-2418 Ph: (865) 280-2123 | Emotional And Behavioral Therapy 915 Eagle View Dr Kodak TN 37764-2418 Ph: (865) 280-2123 |
| NPI Number | 1174107965 |
|---|---|
| Provider Enumeration Date | 05/08/2021 |
| Last Update Date | 05/08/2021 |
| Certification Date | 05/08/2021 |
| Medicare PECOS PAC ID | 6901200484 |
|---|---|
| Medicare Enrollment ID | O20210805000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174107965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Claudia Renee Hirsemann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356610919 PECOS PAC ID: 7315375557 Enrollment ID: I20210805000591 |
Restoration House Ministries Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2450 Winfield Dunn Pkwy, Kodak, TN 37764 Phone: 865-805-0567 |