| Katara Therapy, Llc | |
|
3665 S Lakeshore Dr Saint Joseph MI 49085-8277 | |
| (269) 993-0942 | |
| (888) 412-1492 |
| Full Name | Katara Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3665 S Lakeshore Dr, Saint Joseph, Michigan |
| Authorized Official Name and Position | Tara Elizabeth Bugg (OWNER/THERAPIST) |
| Authorized Official Contact | 2699930942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katara Therapy, Llc 13560 76th St Ste 3 South Haven MI 49090-9483 Ph: (269) 993-0942 | Katara Therapy, Llc 3665 S Lakeshore Dr Saint Joseph MI 49085-8277 Ph: (269) 993-0942 |
| NPI Number | 1295234490 |
|---|---|
| Provider Enumeration Date | 02/03/2018 |
| Last Update Date | 03/01/2021 |
| Certification Date | 03/01/2021 |
| Medicare PECOS PAC ID | 4385056043 |
|---|---|
| Medicare Enrollment ID | O20201222001218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295234490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801098010 (Michigan) | Primary |
| 1041C0700X | Social Worker - Clinical | 6801094765 (Michigan) | Secondary |
| Provider Name | Tara Bugg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689054736 PECOS PAC ID: 8729416193 Enrollment ID: I20200318000278 |
| Provider Name | Katrina Sternaman-rosenbaum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982024311 PECOS PAC ID: 4587076260 Enrollment ID: I20210119002408 |
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