| Helen Maria Llc | |
|
4431 S Walnut Street Pike Bloomington IN 47401-9094 | |
| (812) 360-3585 | |
| Not Available |
| Full Name | Helen Maria Llc |
|---|---|
| Speciality | Counselor |
| Location | 4431 S Walnut Street Pike, Bloomington, Indiana |
| Authorized Official Name and Position | Helen Maria Johnston (OWNER) |
| Authorized Official Contact | 8123603585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Helen Maria Llc 4431 S Walnut Street Pike Bloomington IN 47401-9094 Ph: () - | Helen Maria Llc 4431 S Walnut Street Pike Bloomington IN 47401-9094 Ph: (812) 360-3585 |
| NPI Number | 1629773379 |
|---|---|
| Provider Enumeration Date | 04/03/2023 |
| Last Update Date | 04/03/2023 |
| Certification Date | 04/03/2023 |
| Medicare PECOS PAC ID | 9638530165 |
|---|---|
| Medicare Enrollment ID | O20230801001575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629773379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Helen M Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386305332 PECOS PAC ID: 3779977038 Enrollment ID: I20220302001609 |
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