| Innovation Therapies, Pllc | |
|
3201 Yorktown Ave Ste 117d Durham NC 27713-1474 | |
| (919) 593-3340 | |
| (919) 550-2397 |
| Full Name | Innovation Therapies, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3201 Yorktown Ave Ste 117d, Durham, North Carolina |
| Authorized Official Name and Position | Denise Shavon Dawson (CEO/OWNER) |
| Authorized Official Contact | 9195933340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovation Therapies, Pllc 756-402 Cl Tart Circle Fayetteville NC 28314 Ph: (919) 593-3340 | Innovation Therapies, Pllc 3201 Yorktown Ave Ste 117d Durham NC 27713-1474 Ph: (919) 593-3340 |
| NPI Number | 1750648457 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 04/20/2018 |
| Medicare PECOS PAC ID | 0042533002 |
|---|---|
| Medicare Enrollment ID | O20141223001173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750648457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Denise Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861899643 PECOS PAC ID: 8123341187 Enrollment ID: I20141229000674 |
| Provider Name | Sonjia Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598860181 PECOS PAC ID: 0042676264 Enrollment ID: I20230515000423 |
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