| Humboldt Counseling Connection | |
|
123 F St Ste F Eureka CA 95501-1048 | |
| (707) 390-0393 | |
| Not Available |
| Full Name | Humboldt Counseling Connection |
|---|---|
| Speciality | Clinic/Center |
| Location | 123 F St Ste F, Eureka, California |
| Authorized Official Name and Position | Tamela Christiansen (DIRECTOR) |
| Authorized Official Contact | 7073900393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Humboldt Counseling Connection 123 F St Ste F Eureka CA 95501-1048 Ph: (707) 390-0393 | Humboldt Counseling Connection 123 F St Ste F Eureka CA 95501-1048 Ph: (707) 390-0393 |
| NPI Number | 1710768411 |
|---|---|
| Provider Enumeration Date | 10/09/2023 |
| Last Update Date | 10/09/2023 |
| Certification Date | 10/09/2023 |
| Medicare PECOS PAC ID | 5193160950 |
|---|---|
| Medicare Enrollment ID | O20240301003864 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710768411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tracy Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114463965 PECOS PAC ID: 5597197939 Enrollment ID: I20191122002310 |
| Provider Name | Lisa Robyn Rix |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376012278 PECOS PAC ID: 7719399427 Enrollment ID: I20201221001948 |
| Provider Name | Tamela Dawn Christiansen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902305279 PECOS PAC ID: 6002251865 Enrollment ID: I20240301003871 |
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