| Peace At Last Therapy, Llc | |
|
677 Woodland Square Loop Se Lacey WA 98503-1000 | |
| (206) 979-4005 | |
| Not Available |
| Full Name | Peace At Last Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 677 Woodland Square Loop Se, Lacey, Washington |
| Authorized Official Name and Position | Penelope N L Pavlinovic (OWNER) |
| Authorized Official Contact | 2069794005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peace At Last Therapy, Llc 700 Sleater Kinney Rd Se Ste B Lacey WA 98503-1113 Ph: (206) 979-4005 | Peace At Last Therapy, Llc 677 Woodland Square Loop Se Lacey WA 98503-1000 Ph: (206) 979-4005 |
| NPI Number | 1184235632 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 07/28/2021 |
| Certification Date | 07/28/2021 |
| Medicare PECOS PAC ID | 8123428752 |
|---|---|
| Medicare Enrollment ID | O20210814000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184235632 | NPI | - | NPPES |
| 1174050629 | Other | WA | KAISER, REGENCE, TRICARE, PREMERA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Penelope Pavlinovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174050629 PECOS PAC ID: 0345644217 Enrollment ID: I20210920001966 |
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