| Into The Light Counseling, Inc. | |
|
353 W 2nd St Clayton NC 27520-2336 | |
| (919) 271-0135 | |
| (888) 503-6822 |
| Full Name | Into The Light Counseling, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 353 W 2nd St, Clayton, North Carolina |
| Authorized Official Name and Position | Andrea Eaves (OWNER/THERAPIST) |
| Authorized Official Contact | 9192710135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Into The Light Counseling, Inc. Po Box 1348 Po Box 1348 Clayton NC 27528-1348 Ph: (919) 271-0135 | Into The Light Counseling, Inc. 353 W 2nd St Clayton NC 27520-2336 Ph: (919) 271-0135 |
| NPI Number | 1689925562 |
|---|---|
| Provider Enumeration Date | 10/02/2012 |
| Last Update Date | 10/02/2012 |
| Medicare PECOS PAC ID | 3870739709 |
|---|---|
| Medicare Enrollment ID | O20130423000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689925562 | NPI | - | NPPES |
| 6003393 | Medicaid | NC | |
| 141C3 | Other | BCBS | |
| 2860031A | Other | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C004198 (North Carolina) | Primary |
| Provider Name | Andrea T Eaves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700837630 PECOS PAC ID: 2365527868 Enrollment ID: I20080307000426 |
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