| Freed From Trauma, Llc | |
|
3510 Kirby Dr Greensboro NC 27403-1021 | |
| (336) 202-5552 | |
| Not Available |
| Full Name | Freed From Trauma, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3510 Kirby Dr, Greensboro, North Carolina |
| Authorized Official Name and Position | Julie Albert (PRESIDENT) |
| Authorized Official Contact | 3362025552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freed From Trauma, Llc 3510 Kirby Dr Greensboro NC 27403-1021 Ph: (336) 202-5552 | Freed From Trauma, Llc 3510 Kirby Dr Greensboro NC 27403-1021 Ph: (336) 202-5552 |
| NPI Number | 1568977254 |
|---|---|
| Provider Enumeration Date | 12/05/2017 |
| Last Update Date | 04/22/2022 |
| Certification Date | 04/22/2022 |
| Medicare PECOS PAC ID | 7315208691 |
|---|---|
| Medicare Enrollment ID | O20180301000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568977254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | C005664 (North Carolina) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Julie Marie Albert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083800791 PECOS PAC ID: 8820138977 Enrollment ID: I20091221000440 |
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