| Healing Circle Psychiatric Services Pllc | |
|
3220 18th St S Ste 7 Fargo ND 58104-6564 | |
| (701) 550-0193 | |
| Not Available |
| Full Name | Healing Circle Psychiatric Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3220 18th St S Ste 7, Fargo, North Dakota |
| Authorized Official Name and Position | Albert Allick (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7015500193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Circle Psychiatric Services Pllc 3220 18th St S Ste 7 Fargo ND 58104-6564 Ph: (701) 550-0193 | Healing Circle Psychiatric Services Pllc 3220 18th St S Ste 7 Fargo ND 58104-6564 Ph: (701) 550-0193 |
| NPI Number | 1407568181 |
|---|---|
| Provider Enumeration Date | 12/14/2022 |
| Last Update Date | 01/26/2023 |
| Certification Date | 01/25/2023 |
| Medicare PECOS PAC ID | 6901271014 |
|---|---|
| Medicare Enrollment ID | O20230403001669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407568181 | NPI | - | NPPES |
| Provider Name | Albert Allick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467534669 PECOS PAC ID: 5496834517 Enrollment ID: I20131003000016 |
| Provider Name | Ann Leuthard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235340928 PECOS PAC ID: 7416496708 Enrollment ID: I20240830000789 |
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