Summit Counseling Inc | |
1500 14th St W Suite 290 Williston ND 58801-4076 | |
(701) 334-6242 | |
(701) 713-3299 |
Full Name | Summit Counseling Inc |
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Speciality | Clinic/Center |
Location | 1500 14th St W, Williston, North Dakota |
Authorized Official Name and Position | Brenda Lee Owen (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7013346242 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Summit Counseling Inc 1500 14th St W Suite 290 Williston ND 58801-4076 Ph: (701) 334-6242 | Summit Counseling Inc 1500 14th St W Suite 290 Williston ND 58801-4076 Ph: (701) 334-6242 |
NPI Number | 1427593698 |
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Provider Enumeration Date | 12/27/2016 |
Last Update Date | 03/15/2020 |
Certification Date | 03/15/2020 |
Medicare PECOS PAC ID | 1153603162 |
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Medicare Enrollment ID | O20170127001347 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427593698 | NPI | - | NPPES |
1472475 | Medicaid | ND |
Provider Name | Brenda L Owen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1346542727 PECOS PAC ID: 6901020007 Enrollment ID: I20140611000975 |
Provider Name | Elizabeth Castillo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710687546 PECOS PAC ID: 0749648350 Enrollment ID: I20230614000559 |
Provider Name | Sara B Fries |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1093261968 PECOS PAC ID: 3678931599 Enrollment ID: I20230623002563 |
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Summit Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 14th St W Ste 290, Williston, ND 58801 Phone: 701-334-6242 Fax: 701-712-3299 |