| Mat-su Mental Health Llc | |
|
860 S Roberts St Ste 200 Wasilla AK 99654-0014 | |
| (907) 313-7965 | |
| Not Available |
| Full Name | Mat-su Mental Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 860 S Roberts St Ste 200, Wasilla, Alaska |
| Authorized Official Name and Position | Micha Savage (OFFICE MANAGER) |
| Authorized Official Contact | 9075313832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mat-su Mental Health Llc Po Box 2653 Soldotna AK 99669-2653 Ph: (907) 444-8355 | Mat-su Mental Health Llc 860 S Roberts St Ste 200 Wasilla AK 99654-0014 Ph: (907) 313-7965 |
| NPI Number | 1245811819 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 11/02/2022 |
| Certification Date | 11/02/2022 |
| Medicare PECOS PAC ID | 1052700994 |
|---|---|
| Medicare Enrollment ID | O20211115000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245811819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn Jane Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992007603 PECOS PAC ID: 4880926773 Enrollment ID: I20191025001252 |
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