| Peaceful Pathways Llc | |
|
2484 S Business 31 Ste D Peru IN 46970-7325 | |
| (765) 472-2722 | |
| Not Available |
| Full Name | Peaceful Pathways Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2484 S Business 31 Ste D, Peru, Indiana |
| Authorized Official Name and Position | Leigh Gibbs (OWNER) |
| Authorized Official Contact | 7654801050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceful Pathways Llc 2484 S Business 31 Ste D Peru IN 46970-7325 Ph: () - | Peaceful Pathways Llc 2484 S Business 31 Ste D Peru IN 46970-7325 Ph: (765) 472-2722 |
| NPI Number | 1689420275 |
|---|---|
| Provider Enumeration Date | 04/25/2024 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/25/2024 |
| Medicare PECOS PAC ID | 9436591443 |
|---|---|
| Medicare Enrollment ID | O20240522002223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689420275 | NPI | - | NPPES |
| 1073371274 | Medicaid | IN | |
| 1346824729 | Other | IN | COMMERCIAL |
| 1346824729 | Medicaid | IN | |
| 1073371274 | Other | IN | COMMERCIAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leigh Danielle Gibbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073371274 PECOS PAC ID: 0345682357 Enrollment ID: I20240522002388 |
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