| Fox And Ferns Mental Health, Llc | |
|
77 Rochelle Ave Philadelphia PA 19128-3809 | |
| (215) 704-9832 | |
| Not Available |
| Full Name | Fox And Ferns Mental Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 77 Rochelle Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Michael E. Keesler (OWNER) |
| Authorized Official Contact | 2157049832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox And Ferns Mental Health, Llc 77 Rochelle Ave Philadelphia PA 19128-3809 Ph: (215) 704-9832 | Fox And Ferns Mental Health, Llc 77 Rochelle Ave Philadelphia PA 19128-3809 Ph: (215) 704-9832 |
| NPI Number | 1184269664 |
|---|---|
| Provider Enumeration Date | 11/08/2019 |
| Last Update Date | 11/08/2019 |
| Medicare PECOS PAC ID | 2466885512 |
|---|---|
| Medicare Enrollment ID | O20191204001937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184269664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michael Edward Keesler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609228022 PECOS PAC ID: 7517246390 Enrollment ID: I20161118000656 |
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