Love Warrior Healing Pc Llo | |
1617 S 17th St Lincoln NE 68502-2602 | |
(402) 570-8430 | |
Not Available |
Full Name | Love Warrior Healing Pc Llo |
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Speciality | Clinic/Center |
Location | 1617 S 17th St, Lincoln, Nebraska |
Authorized Official Name and Position | Mary Meghan Davidson (OWNER/PSYCHOLOGIST) |
Authorized Official Contact | 4025708430 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Love Warrior Healing Pc Llo 1627 S 17th St Lincoln NE 68502-2602 Ph: (402) 570-8430 | Love Warrior Healing Pc Llo 1617 S 17th St Lincoln NE 68502-2602 Ph: (402) 570-8430 |
NPI Number | 1104686054 |
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Provider Enumeration Date | 03/19/2024 |
Last Update Date | 03/26/2024 |
Certification Date | 03/26/2024 |
Medicare PECOS PAC ID | 3274974795 |
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Medicare Enrollment ID | O20240515003152 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104686054 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Mary M Davidson |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1922252493 PECOS PAC ID: 3375873185 Enrollment ID: I20190920002323 |
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