| Radical Healing Llc | |
|
300 E Horsetooth Rd Ste 200 Fort Collins CO 80525-3154 | |
| (970) 236-6317 | |
| Not Available |
| Full Name | Radical Healing Llc |
|---|---|
| Speciality | Counselor |
| Location | 300 E Horsetooth Rd Ste 200, Fort Collins, Colorado |
| Authorized Official Name and Position | Bernadette Pivarunas (FOUNDER & DIRECTOR) |
| Authorized Official Contact | 9702366317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radical Healing Llc 300 E Horsetooth Rd Ste 200 Fort Collins CO 80525-3154 Ph: () - | Radical Healing Llc 300 E Horsetooth Rd Ste 200 Fort Collins CO 80525-3154 Ph: (970) 236-6317 |
| NPI Number | 1386282523 |
|---|---|
| Provider Enumeration Date | 12/18/2019 |
| Last Update Date | 12/18/2019 |
| Certification Date | 12/18/2019 |
| Medicare PECOS PAC ID | 8527422682 |
|---|---|
| Medicare Enrollment ID | O20240328000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386282523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| Provider Name | Bernadette Pivarunas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316432842 PECOS PAC ID: 7214279504 Enrollment ID: I20240328000883 |
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