| Lasting Wellness Llc | |
|
116 Depot St Apt 2 Clarks Summit PA 18411-1878 | |
| (570) 507-7649 | |
| Not Available |
| Full Name | Lasting Wellness Llc |
|---|---|
| Speciality | Psychologist |
| Location | 116 Depot St Apt 2, Clarks Summit, Pennsylvania |
| Authorized Official Name and Position | Lindsay St Thomas (OWNER) |
| Authorized Official Contact | 8582041082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lasting Wellness Llc 6 Belle Ter Covington Twp PA 18424-7809 Ph: (858) 204-1082 | Lasting Wellness Llc 116 Depot St Apt 2 Clarks Summit PA 18411-1878 Ph: (570) 507-7649 |
| NPI Number | 1922649987 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 5991138216 |
|---|---|
| Medicare Enrollment ID | O20191127000798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922649987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lindsay A St Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093889842 PECOS PAC ID: 2668630807 Enrollment ID: I20170518002651 |
| Provider Name | Sarah Pettinato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669915302 PECOS PAC ID: 3375808082 Enrollment ID: I20180530002309 |
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