| Jovial Therapy Services Llc | |
|
43335 Kalifornsky Beach Rd Bld D, Ste C Soldotna AK 99669-8250 | |
| (907) 953-3257 | |
| (907) 802-6826 |
| Full Name | Jovial Therapy Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 43335 Kalifornsky Beach Rd Bld D, Ste C, Soldotna, Alaska |
| Authorized Official Name and Position | Nicole Palacios (PROVIDER / OWNER) |
| Authorized Official Contact | 9079533257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jovial Therapy Services Llc 43335 Kalifronsky Beach Road Bld D Ste C Soldotna AK 99669-9231 Ph: (907) 953-3257 | Jovial Therapy Services Llc 43335 Kalifornsky Beach Rd Bld D, Ste C Soldotna AK 99669-8250 Ph: (907) 953-3257 |
| NPI Number | 1992584585 |
|---|---|
| Provider Enumeration Date | 09/25/2023 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 8224488580 |
|---|---|
| Medicare Enrollment ID | O20231228002156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992584585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nicole Isabell Palacios |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962902437 PECOS PAC ID: 9133579493 Enrollment ID: I20231228002204 |
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