| Indigo Rivers Neurofeedback And Counseling | |
|
4711 Seminole Ct Winston Salem NC 27127-9432 | |
| (336) 416-1533 | |
| Not Available |
| Full Name | Indigo Rivers Neurofeedback And Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 4711 Seminole Ct, Winston Salem, North Carolina |
| Authorized Official Name and Position | Kimberley R. Hunt (OWNER) |
| Authorized Official Contact | 3364161533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Rivers Neurofeedback And Counseling 4711 Seminole Ct Winston Salem NC 27127-9432 Ph: (336) 416-1533 | Indigo Rivers Neurofeedback And Counseling 4711 Seminole Ct Winston Salem NC 27127-9432 Ph: (336) 416-1533 |
| NPI Number | 1073228847 |
|---|---|
| Provider Enumeration Date | 01/17/2023 |
| Last Update Date | 07/29/2023 |
| Certification Date | 07/29/2023 |
| Medicare PECOS PAC ID | 2264895622 |
|---|---|
| Medicare Enrollment ID | O20230831004533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073228847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kimberley Renee Hunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285103812 PECOS PAC ID: 1254749757 Enrollment ID: I20210422001097 |
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