| Lisa Blosser, Pllc, Psychotherapy | |
|
7000 Hampton Ctr Ste H Morgantown WV 26505-1762 | |
| (304) 440-6810 | |
| (617) 865-7064 |
| Full Name | Lisa Blosser, Pllc, Psychotherapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 7000 Hampton Ctr Ste H, Morgantown, West Virginia |
| Authorized Official Name and Position | Lisa Blosser (OWNER) |
| Authorized Official Contact | 3046857652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Blosser, Pllc, Psychotherapy 7000 Hampton Ctr Ste H Morgantown WV 26505-1762 Ph: (304) 440-6810 | Lisa Blosser, Pllc, Psychotherapy 7000 Hampton Ctr Ste H Morgantown WV 26505-1762 Ph: (304) 440-6810 |
| NPI Number | 1508627472 |
|---|---|
| Provider Enumeration Date | 01/18/2024 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Medicare PECOS PAC ID | 9931548203 |
|---|---|
| Medicare Enrollment ID | O20240418004075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508627472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lisa Blosser |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1215100797 PECOS PAC ID: 1951489665 Enrollment ID: I20240430002470 |
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