| Gail A Truitt Licsw Counseling Services S Corp | |
|
27121 174th Pl Se Ste 100 Covington WA 98042-4939 | |
| (253) 630-5434 | |
| (253) 638-7465 |
| Full Name | Gail A Truitt Licsw Counseling Services S Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 27121 174th Pl Se Ste 100, Covington, Washington |
| Authorized Official Name and Position | Gail Truitt (PRESIDENT/SOLE EMPLOYEE) |
| Authorized Official Contact | 2536305434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gail A Truitt Licsw Counseling Services S Corp 27121 174th Pl Se Ste 100 Covington WA 98042-4939 Ph: (253) 630-5434 | Gail A Truitt Licsw Counseling Services S Corp 27121 174th Pl Se Ste 100 Covington WA 98042-4939 Ph: (253) 630-5434 |
| NPI Number | 1134871916 |
|---|---|
| Provider Enumeration Date | 01/22/2022 |
| Last Update Date | 04/11/2022 |
| Certification Date | 04/11/2022 |
| Medicare PECOS PAC ID | 8123413143 |
|---|---|
| Medicare Enrollment ID | O20220309002404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134871916 | NPI | - | NPPES |
| 1033283577 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gail A Truitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033283577 PECOS PAC ID: 5395893234 Enrollment ID: I20090501000349 |
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