| Shannon Deets Counseling Llc | |
|
898 Park Ave Suite 16 Meadville PA 16335-3335 | |
| (814) 807-0487 | |
| Not Available |
| Full Name | Shannon Deets Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 898 Park Ave, Meadville, Pennsylvania |
| Authorized Official Name and Position | Shannon Deets (OWNER) |
| Authorized Official Contact | 8148070487 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Deets Counseling Llc 898 Park Ave Suite 16 Meadville PA 16335-3335 Ph: () - | Shannon Deets Counseling Llc 898 Park Ave Suite 16 Meadville PA 16335-3335 Ph: (814) 807-0487 |
| NPI Number | 1275950693 |
|---|---|
| Provider Enumeration Date | 03/24/2014 |
| Last Update Date | 03/24/2014 |
| Medicare PECOS PAC ID | 3274960117 |
|---|---|
| Medicare Enrollment ID | O20200305001032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275950693 | NPI | - | NPPES |
| 1912153289 | Other | NPI | |
| 1024531890002 | Medicaid | PA | |
| 1205938008 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PC004908 (Pennsylvania) | Primary |
| 1041C0700X | Social Worker - Clinical | CW003132L (Pennsylvania) | Secondary |
| Provider Name | Shannon L Deets |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912153289 PECOS PAC ID: 4486982972 Enrollment ID: I20190821004084 |
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