| Momentum Counseling Llc | |
|
927 Main St Racine WI 53403-1524 | |
| (262) 770-5184 | |
| Not Available |
| Full Name | Momentum Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 927 Main St, Racine, Wisconsin |
| Authorized Official Name and Position | Lakeisha Monique Woods (OWNER) |
| Authorized Official Contact | 2629950722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Momentum Counseling Llc 4815 Conlaine Dr Racine WI 53402-2557 Ph: (262) 995-0722 | Momentum Counseling Llc 927 Main St Racine WI 53403-1524 Ph: (262) 770-5184 |
| NPI Number | 1639669864 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 02/25/2019 |
| Medicare PECOS PAC ID | 9537410543 |
|---|---|
| Medicare Enrollment ID | O20181001001158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639669864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8711-123 (Wisconsin) | Primary |
| Provider Name | Lakeisha M Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285169276 PECOS PAC ID: 3173800943 Enrollment ID: I20170503001990 |
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