| Mls Mindful Therapy Pc | |
|
135 Technology Dr Ste 312 Canonsburg PA 15317-9549 | |
| (724) 413-4306 | |
| Not Available |
| Full Name | Mls Mindful Therapy Pc |
|---|---|
| Speciality | Social Worker |
| Location | 135 Technology Dr Ste 312, Canonsburg, Pennsylvania |
| Authorized Official Name and Position | Mary Lou Silvestros (OWNER) |
| Authorized Official Contact | 7244134306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mls Mindful Therapy Pc 135 Technology Dr Ste 312 Canonsburg PA 15317-9549 Ph: (724) 413-4306 | Mls Mindful Therapy Pc 135 Technology Dr Ste 312 Canonsburg PA 15317-9549 Ph: (724) 413-4306 |
| NPI Number | 1790307130 |
|---|---|
| Provider Enumeration Date | 05/08/2020 |
| Last Update Date | 01/15/2024 |
| Certification Date | 01/15/2024 |
| Medicare PECOS PAC ID | 2961823703 |
|---|---|
| Medicare Enrollment ID | O20200602002162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790307130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mary Silvestros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164812525 PECOS PAC ID: 0840508107 Enrollment ID: I20151006001991 |
| Provider Name | Kenneth E Riddle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962074203 PECOS PAC ID: 9739526518 Enrollment ID: I20240328002633 |
| Provider Name | Eva Jeanne Kramer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144522715 PECOS PAC ID: 6103265384 Enrollment ID: I20240421000014 |
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