Life Paths Counseling, Llc | |
101 W Kirkwood Ave Ste 222 Bloomington IN 47404-6133 | |
(812) 361-1234 | |
Not Available |
Full Name | Life Paths Counseling, Llc |
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Speciality | Social Worker |
Location | 101 W Kirkwood Ave Ste 222, Bloomington, Indiana |
Authorized Official Name and Position | Heather M Hudson (OWNER) |
Authorized Official Contact | 8123611234 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Life Paths Counseling, Llc 101 W Kirkwood Ave Ste 222 Bloomington IN 47404-6133 Ph: (812) 361-1234 | Life Paths Counseling, Llc 101 W Kirkwood Ave Ste 222 Bloomington IN 47404-6133 Ph: (812) 361-1234 |
NPI Number | 1366883274 |
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Provider Enumeration Date | 07/09/2013 |
Last Update Date | 12/22/2014 |
Medicare PECOS PAC ID | 0648413872 |
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Medicare Enrollment ID | O20130906000611 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366883274 | NPI | - | NPPES |
IN1464 | Other | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 34005660A (Indiana) | Primary |
Provider Name | Heather Marie Hudson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1083057137 PECOS PAC ID: 1557504784 Enrollment ID: I20130906000639 |
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