| Miami Valley Integrated Psychotherapy Llc | |
|
7061 Corporate Way Dayton OH 45459-4273 | |
| (937) 304-1615 | |
| (937) 439-2984 |
| Full Name | Miami Valley Integrated Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7061 Corporate Way, Dayton, Ohio |
| Authorized Official Name and Position | Amanda K Matthias (OWNER/PROVIDER) |
| Authorized Official Contact | 9373041615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miami Valley Integrated Psychotherapy Llc 1055 E Centerville Station Rd Dayton OH 45459-5500 Ph: (937) 439-2984 | Miami Valley Integrated Psychotherapy Llc 7061 Corporate Way Dayton OH 45459-4273 Ph: (937) 304-1615 |
| NPI Number | 1033547617 |
|---|---|
| Provider Enumeration Date | 10/17/2013 |
| Last Update Date | 05/05/2023 |
| Certification Date | 05/05/2023 |
| Medicare PECOS PAC ID | 2860620945 |
|---|---|
| Medicare Enrollment ID | O20140117000648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033547617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amanda K Matthias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275552770 PECOS PAC ID: 7517934391 Enrollment ID: I20040911000315 |
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