| Golden Years Therapy Llc | |
|
51743 Inverness Dr South Bend IN 46628-9555 | |
| (860) 882-2516 | |
| Not Available |
| Full Name | Golden Years Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 51743 Inverness Dr, South Bend, Indiana |
| Authorized Official Name and Position | Sara Lichtenwalter (CEO) |
| Authorized Official Contact | 8608822516 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Years Therapy Llc 51743 Inverness Dr South Bend IN 46628-9555 Ph: (860) 882-2516 | Golden Years Therapy Llc 51743 Inverness Dr South Bend IN 46628-9555 Ph: (860) 882-2516 |
| NPI Number | 1295516854 |
|---|---|
| Provider Enumeration Date | 10/10/2023 |
| Last Update Date | 10/10/2023 |
| Certification Date | 10/10/2023 |
| Medicare PECOS PAC ID | 6103275094 |
|---|---|
| Medicare Enrollment ID | O20231218003759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295516854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sara Lichtenwalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811413677 PECOS PAC ID: 9931585726 Enrollment ID: I20220930002866 |
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