| Somatic Latitude, Llc | |
|
555 Poyntz Ave Ste 282 Manhattan KS 66502-6085 | |
| (785) 301-1542 | |
| (785) 262-8393 |
| Full Name | Somatic Latitude, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 555 Poyntz Ave Ste 282, Manhattan, Kansas |
| Authorized Official Name and Position | Angela C Givian (MANAGER) |
| Authorized Official Contact | 7853011542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Somatic Latitude, Llc 555 Poyntz Ave Ste 282 Manhattan KS 66502-6085 Ph: (785) 301-1542 | Somatic Latitude, Llc 555 Poyntz Ave Ste 282 Manhattan KS 66502-6085 Ph: (785) 301-1542 |
| NPI Number | 1982487229 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 09/27/2024 |
| Certification Date | 09/27/2024 |
| Medicare PECOS PAC ID | 3779939814 |
|---|---|
| Medicare Enrollment ID | O20231026001580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982487229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Givian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366071086 PECOS PAC ID: 4082077094 Enrollment ID: I20230823003923 |
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