| Healing Strides Psychotherapy, Inc. | |
|
Po Box 1006 Blue Lake CA 95525-1006 | |
| (707) 845-8737 | |
| Not Available |
| Full Name | Healing Strides Psychotherapy, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | Po Box 1006, Blue Lake, California |
| Authorized Official Name and Position | Terri Elana Jennings (PRESIDENT) |
| Authorized Official Contact | 7078458737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Strides Psychotherapy, Inc. Po Box 1006 Blue Lake CA 95525-1006 Ph: (707) 845-8737 | Healing Strides Psychotherapy, Inc. Po Box 1006 Blue Lake CA 95525-1006 Ph: (707) 845-8737 |
| NPI Number | 1124400155 |
|---|---|
| Provider Enumeration Date | 06/26/2015 |
| Last Update Date | 08/19/2019 |
| Medicare PECOS PAC ID | 3173831674 |
|---|---|
| Medicare Enrollment ID | O20151002001186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124400155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PSY27263 (California) | Primary |
| Provider Name | Terri Elana Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568611861 PECOS PAC ID: 6608930581 Enrollment ID: I20151002000969 |
| Provider Name | Melissa Alton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245764638 PECOS PAC ID: 2961810585 Enrollment ID: I20210421000236 |
| Provider Name | Erica Annee Ashby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518314129 PECOS PAC ID: 5193101707 Enrollment ID: I20221005002853 |