| Kpb Wewer, Llc | |
|
47 W Pomfret St Carlisle PA 17013-3217 | |
| (717) 258-0214 | |
| (717) 258-3158 |
| Full Name | Kpb Wewer, Llc |
|---|---|
| Speciality | Counselor |
| Location | 47 W Pomfret St, Carlisle, Pennsylvania |
| Authorized Official Name and Position | Kristin P Brenize-wewer (OWNER) |
| Authorized Official Contact | 7172580214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kpb Wewer, Llc 47 W Pomfret St Carlisle PA 17013-3217 Ph: (717) 258-0214 | Kpb Wewer, Llc 47 W Pomfret St Carlisle PA 17013-3217 Ph: (717) 258-0214 |
| NPI Number | 1932751740 |
|---|---|
| Provider Enumeration Date | 07/11/2019 |
| Last Update Date | 07/11/2019 |
| Medicare PECOS PAC ID | 0446662308 |
|---|---|
| Medicare Enrollment ID | O20201217000706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932751740 | NPI | - | NPPES |
| Provider Name | Jerry F Mock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417959354 PECOS PAC ID: 4385673623 Enrollment ID: I20050808000556 |
| Provider Name | Dyanne M Sage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750395141 PECOS PAC ID: 3678700853 Enrollment ID: I20131213001095 |
| Provider Name | Maria E Degaetano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356665699 PECOS PAC ID: 5395179634 Enrollment ID: I20191219002411 |
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