Prudent Psychological Services | |
309 E Main St Ste 5 Auburn WA 98002-5540 | |
(253) 434-3825 | |
Not Available |
Full Name | Prudent Psychological Services |
---|---|
Speciality | Counselor |
Location | 309 E Main St Ste 5, Auburn, Washington |
Authorized Official Name and Position | Ferlicia Fergusson-prudent (OWNER) |
Authorized Official Contact | 2539872424 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Prudent Psychological Services 309 E Main St Ste 5 Auburn WA 98002-5540 Ph: (253) 434-3825 | Prudent Psychological Services 309 E Main St Ste 5 Auburn WA 98002-5540 Ph: (253) 434-3825 |
NPI Number | 1386429082 |
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Provider Enumeration Date | 08/30/2023 |
Last Update Date | 11/07/2023 |
Certification Date | 11/07/2023 |
Medicare PECOS PAC ID | 9032561121 |
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Medicare Enrollment ID | O20240112004097 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386429082 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Ferlicia Fergusson-prudent |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1205317211 PECOS PAC ID: 4587016670 Enrollment ID: I20241023002114 |
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