| Helena Bloomingdale Licsw Llc | |
|
10 Mckenney Cir Andover MA 01810-1313 | |
| (617) 710-1368 | |
| Not Available |
| Full Name | Helena Bloomingdale Licsw Llc |
|---|---|
| Speciality | Counselor |
| Location | 10 Mckenney Cir, Andover, Massachusetts |
| Authorized Official Name and Position | Helena Bloomingdale (OWNER) |
| Authorized Official Contact | 6177101368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Helena Bloomingdale Licsw Llc 10 Mckenney Cir Andover MA 01810-1313 Ph: (617) 710-1368 | Helena Bloomingdale Licsw Llc 10 Mckenney Cir Andover MA 01810-1313 Ph: (617) 710-1368 |
| NPI Number | 1871229138 |
|---|---|
| Provider Enumeration Date | 07/28/2022 |
| Last Update Date | 07/28/2022 |
| Certification Date | 07/28/2022 |
| Medicare PECOS PAC ID | 8224494513 |
|---|---|
| Medicare Enrollment ID | O20230511000332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871229138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Helena S Bloomingdale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104900117 PECOS PAC ID: 1557369154 Enrollment ID: I20061114000581 |
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