| Journey To A Trauma-informed Life | |
|
201 W 11th St Erie PA 16501-1701 | |
| (814) 397-7480 | |
| (814) 315-9564 |
| Full Name | Journey To A Trauma-informed Life |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 201 W 11th St, Erie, Pennsylvania |
| Authorized Official Name and Position | William Jackson Koehler (PARTNER) |
| Authorized Official Contact | 8143977480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey To A Trauma-informed Life 201 W 11th St Erie PA 16501-1701 Ph: (814) 397-7480 | Journey To A Trauma-informed Life 201 W 11th St Erie PA 16501-1701 Ph: (814) 397-7480 |
| NPI Number | 1518522242 |
|---|---|
| Provider Enumeration Date | 05/08/2019 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 3274943030 |
|---|---|
| Medicare Enrollment ID | O20201105001445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518522242 | NPI | - | NPPES |
| Provider Name | William J Koehler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699904227 PECOS PAC ID: 8921279456 Enrollment ID: I20110914000067 |
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