| Shasta Treatment Center | |
|
2030 Hartnell Ave Suite D Redding CA 96002-5070 | |
| (530) 221-6237 | |
| (530) 222-5128 |
| Full Name | Shasta Treatment Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2030 Hartnell Ave, Redding, California |
| Authorized Official Name and Position | Barbara Irene Gephart (DIRECTOR) |
| Authorized Official Contact | 5302216237 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shasta Treatment Center 2030 Hartnell Ave Suite D Redding CA 96002-5070 Ph: (530) 221-6237 | Shasta Treatment Center 2030 Hartnell Ave Suite D Redding CA 96002-5070 Ph: (530) 221-6237 |
| NPI Number | 1083885347 |
|---|---|
| Provider Enumeration Date | 03/14/2008 |
| Last Update Date | 01/11/2011 |
| Medicare PECOS PAC ID | 3072952340 |
|---|---|
| Medicare Enrollment ID | O20240910001120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083885347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFT8315 (California) | Primary |
| Provider Name | Barbara Irene Gephart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457480998 PECOS PAC ID: 2567808595 Enrollment ID: I20241023000813 |
| Provider Name | Robin Keith Johnston |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104063999 PECOS PAC ID: 1658804000 Enrollment ID: I20241024000878 |
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