| Summit Clinical Services Llc | |
|
816 Washington St Manitowoc WI 54220-4537 | |
| (262) 719-5177 | |
| Not Available |
| Full Name | Summit Clinical Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 816 Washington St, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Rebecca A Richards (OWNER) |
| Authorized Official Contact | 2627195177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Clinical Services Llc 816 Washington St Manitowoc WI 54220-4537 Ph: () - | Summit Clinical Services Llc 816 Washington St Manitowoc WI 54220-4537 Ph: (262) 719-5177 |
| NPI Number | 1417605551 |
|---|---|
| Provider Enumeration Date | 03/17/2022 |
| Last Update Date | 07/14/2024 |
| Certification Date | 07/14/2024 |
| Medicare PECOS PAC ID | 4486095486 |
|---|---|
| Medicare Enrollment ID | O20240508001756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417605551 | NPI | - | NPPES |
| Provider Name | Rebecca A Richards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225531353 PECOS PAC ID: 5395186399 Enrollment ID: I20240508001821 |
| Provider Name | Nicole Bonin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114701349 PECOS PAC ID: 7517308521 Enrollment ID: I20240508001976 |
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