Mind Renewal Therapy, Llc | |
3755 E State St Ste 6 Hermitage PA 16148-3410 | |
(724) 734-6310 | |
Not Available |
Full Name | Mind Renewal Therapy, Llc |
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Speciality | Social Worker |
Location | 3755 E State St Ste 6, Hermitage, Pennsylvania |
Authorized Official Name and Position | Stephanie Marugg (PRESIDENT/THERAPIST) |
Authorized Official Contact | 7247346310 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mind Renewal Therapy, Llc 3755 E State St Ste 6 Hermitage PA 16148-3410 Ph: (724) 734-6310 | Mind Renewal Therapy, Llc 3755 E State St Ste 6 Hermitage PA 16148-3410 Ph: (724) 734-6310 |
NPI Number | 1356012066 |
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Provider Enumeration Date | 09/22/2021 |
Last Update Date | 09/22/2021 |
Certification Date | 09/22/2021 |
Medicare PECOS PAC ID | 6507255072 |
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Medicare Enrollment ID | O20211123000787 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356012066 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Stephanie Kay Marugg |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285078303 PECOS PAC ID: 8325325988 Enrollment ID: I20170509000059 |
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