| Equilibrium Llc | |
|
223 Windsor Dr Ste 3 Mt Sterling KY 40353-1626 | |
| (859) 274-3066 | |
| Not Available |
| Full Name | Equilibrium Llc |
|---|---|
| Speciality | Social Worker |
| Location | 223 Windsor Dr Ste 3, Mt Sterling, Kentucky |
| Authorized Official Name and Position | Misty Frazier (OWNER/LCSW) |
| Authorized Official Contact | 8592743066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Equilibrium Llc 223 Windsor Dr Ste 3 Mt Sterling KY 40353-1626 Ph: (859) 404-4649 | Equilibrium Llc 223 Windsor Dr Ste 3 Mt Sterling KY 40353-1626 Ph: (859) 274-3066 |
| NPI Number | 1104465889 |
|---|---|
| Provider Enumeration Date | 12/30/2019 |
| Last Update Date | 02/01/2022 |
| Certification Date | 02/01/2022 |
| Medicare PECOS PAC ID | 4688087802 |
|---|---|
| Medicare Enrollment ID | O20210107002312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104465889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Misty Blue Frazier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548507056 PECOS PAC ID: 6305126095 Enrollment ID: I20161215001725 |
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