| Stepping Toward Serenity | |
|
108 Chickadee Trl Georgetown KY 40324-2105 | |
| (513) 206-3026 | |
| (513) 620-5642 |
| Full Name | Stepping Toward Serenity |
|---|---|
| Speciality | Counselor |
| Location | 108 Chickadee Trl, Georgetown, Kentucky |
| Authorized Official Name and Position | Teresa Jacobson (PRINCIPLE OWNER) |
| Authorized Official Contact | 5132063026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stepping Toward Serenity 120 Market Place Cir Ste C-182 Georgetown KY 40324-7205 Ph: (513) 206-3026 | Stepping Toward Serenity 108 Chickadee Trl Georgetown KY 40324-2105 Ph: (513) 206-3026 |
| NPI Number | 1043835929 |
|---|---|
| Provider Enumeration Date | 06/16/2020 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 1355789108 |
|---|---|
| Medicare Enrollment ID | O20240329001742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043835929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Teresa Jacobson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033665716 PECOS PAC ID: 1052759800 Enrollment ID: I20240329001946 |
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