Spectra Support Services, Llc | |
390 Reed Rd Fl 1 Broomall PA 19008-4008 | |
(484) 450-6476 | |
(484) 450-6476 |
Full Name | Spectra Support Services, Llc |
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Speciality | Social Worker |
Location | 390 Reed Rd Fl 1, Broomall, Pennsylvania |
Authorized Official Name and Position | Maleita Marguerite Olson (DIRECTOR/ CO-OWNER) |
Authorized Official Contact | 4844506476 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Spectra Support Services, Llc 390 Reed Rd Fl 1 Broomall PA 19008-4008 Ph: (484) 450-6476 | Spectra Support Services, Llc 390 Reed Rd Fl 1 Broomall PA 19008-4008 Ph: (484) 450-6476 |
NPI Number | 1134482409 |
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Provider Enumeration Date | 06/20/2012 |
Last Update Date | 04/02/2020 |
Certification Date | 04/02/2020 |
Medicare PECOS PAC ID | 9133364045 |
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Medicare Enrollment ID | O20130419000308 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134482409 | NPI | - | NPPES |
1027817150022 | Medicaid | PA | |
1027817150023 | Medicaid | PA | |
1027817150024 | Medicaid | PA | |
1027817150019 | Medicaid | PA | |
1027817150021 | Medicaid | PA | |
1027817150020 | Medicaid | PA |
Provider Name | Karen Elizabeth Weiss |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1861042566 PECOS PAC ID: 4284965369 Enrollment ID: I20191004001191 |
Provider Name | Christine Marie Nelson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649815960 PECOS PAC ID: 5597173708 Enrollment ID: I20210427002482 |
Provider Name | Ashley Nicole Begley |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1609496942 PECOS PAC ID: 4284014036 Enrollment ID: I20220711001352 |
Provider Name | Suzanne Marie Muldoon |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1174831663 PECOS PAC ID: 1355792862 Enrollment ID: I20240109004116 |
Provider Name | Patricia Jane Gonzalez |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1396085387 PECOS PAC ID: 7618113507 Enrollment ID: I20240112004174 |
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