| Forever Evolving Psychotherapy Pllc | |
|
500 Se Everett Mall Way Ste B202 Everett WA 98208-8122 | |
| (425) 953-3910 | |
| Not Available |
| Full Name | Forever Evolving Psychotherapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 500 Se Everett Mall Way Ste B202, Everett, Washington |
| Authorized Official Name and Position | Erika Vannesa Mora (OWNER) |
| Authorized Official Contact | 4259533910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forever Evolving Psychotherapy Pllc 500 Se Everett Mall Way Ste B202 Everett WA 98208-8122 Ph: (425) 953-3910 | Forever Evolving Psychotherapy Pllc 500 Se Everett Mall Way Ste B202 Everett WA 98208-8122 Ph: (425) 953-3910 |
| NPI Number | 1386200764 |
|---|---|
| Provider Enumeration Date | 05/12/2019 |
| Last Update Date | 05/13/2019 |
| Medicare PECOS PAC ID | 4981937547 |
|---|---|
| Medicare Enrollment ID | O20190613001003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386200764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Erika Vannesa Mora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396051710 PECOS PAC ID: 5890028450 Enrollment ID: I20190613001082 |
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