Harvest Moon Mental Health Services, Llc | |
1509 E Superior St Apt 203 Duluth MN 55812-4402 | |
(218) 251-3686 | |
(218) 216-8983 |
Full Name | Harvest Moon Mental Health Services, Llc |
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Speciality | Social Worker |
Location | 1509 E Superior St Apt 203, Duluth, Minnesota |
Authorized Official Name and Position | Corrie R Ehrbright (OWNER/PSYCHOTHERAPIST) |
Authorized Official Contact | 2182704449 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Harvest Moon Mental Health Services, Llc 1509 E Superior St Apt 203 Duluth MN 55812-4402 Ph: (218) 251-3686 | Harvest Moon Mental Health Services, Llc 1509 E Superior St Apt 203 Duluth MN 55812-4402 Ph: (218) 251-3686 |
NPI Number | 1497366611 |
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Provider Enumeration Date | 08/11/2020 |
Last Update Date | 03/18/2021 |
Certification Date | 08/24/2020 |
Medicare PECOS PAC ID | 7315350816 |
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Medicare Enrollment ID | O20201230000187 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497366611 | NPI | - | NPPES |
1538618566 | Other | MN | MENTAL HEALTH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Corrie R Ehrbright |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538618566 PECOS PAC ID: 3971866872 Enrollment ID: I20180405001963 |
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