| Pine View Counseling And Consulting Pllc | |
|
4029 Old Tyler Rd Nacogdoches TX 75964-1425 | |
| (936) 615-9014 | |
| Not Available |
| Full Name | Pine View Counseling And Consulting Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4029 Old Tyler Rd, Nacogdoches, Texas |
| Authorized Official Name and Position | Kallie Krawietz (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9366159014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine View Counseling And Consulting Pllc 4029 Old Tyler Rd Nacogdoches TX 75964-1425 Ph: (936) 615-9014 | Pine View Counseling And Consulting Pllc 4029 Old Tyler Rd Nacogdoches TX 75964-1425 Ph: (936) 615-9014 |
| NPI Number | 1487477691 |
|---|---|
| Provider Enumeration Date | 11/05/2024 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/05/2024 |
| Medicare PECOS PAC ID | 4183159437 |
|---|---|
| Medicare Enrollment ID | O20241122001717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487477691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kallie Krawietz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255761813 PECOS PAC ID: 5092240341 Enrollment ID: I20241122001871 |
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