| Kindbridge, Inc | |
|
200 W Martin Luther King Blvd Ste 1000 Chattanooga TN 37402-2571 | |
| (404) 414-3700 | |
| Not Available |
| Full Name | Kindbridge, Inc |
|---|---|
| Speciality | Counselor |
| Location | 200 W Martin Luther King Blvd Ste 1000, Chattanooga, Tennessee |
| Authorized Official Name and Position | Robert C Jordshaugen (COO) |
| Authorized Official Contact | 4044143700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kindbridge, Inc 200 W Martin Luther King Blvd Ste 1000 Chattanooga TN 37402-2571 Ph: (404) 414-3700 | Kindbridge, Inc 200 W Martin Luther King Blvd Ste 1000 Chattanooga TN 37402-2571 Ph: (404) 414-3700 |
| NPI Number | 1952916124 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Medicare PECOS PAC ID | 6608281563 |
|---|---|
| Medicare Enrollment ID | O20210226002276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952916124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kristen Haflett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598906281 PECOS PAC ID: 7113342585 Enrollment ID: I20210301000191 |
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