Progressive Movement Inc. | |
16041 Kamana Rd Ste A Apple Valley CA 92307-1331 | |
(760) 442-5513 | |
Not Available |
Full Name | Progressive Movement Inc. |
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Speciality | Social Worker |
Location | 16041 Kamana Rd Ste A, Apple Valley, California |
Authorized Official Name and Position | Teri Marie Martin (MENTAL HEALTH THERAPIST) |
Authorized Official Contact | 7604425513 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Progressive Movement Inc. 16041 Kamana Rd Ste A Apple Valley CA 92307-1331 Ph: (760) 442-5513 | Progressive Movement Inc. 16041 Kamana Rd Ste A Apple Valley CA 92307-1331 Ph: (760) 442-5513 |
NPI Number | 1720736473 |
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Provider Enumeration Date | 03/11/2022 |
Last Update Date | 03/11/2022 |
Certification Date | 03/11/2022 |
Medicare PECOS PAC ID | 3870970379 |
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Medicare Enrollment ID | O20220523002657 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720736473 | NPI | - | NPPES |
LCSW-101451 | Other | CA | BBS NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Teri M Martin |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1174835409 PECOS PAC ID: 0244625135 Enrollment ID: I20220310002123 |
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