| Susannah Shell-phillips Pllc | |
|
1101 4th St Fl 2 Sioux City IA 51101-1952 | |
| (712) 490-0006 | |
| Not Available |
| Full Name | Susannah Shell-phillips Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1101 4th St Fl 2, Sioux City, Iowa |
| Authorized Official Name and Position | Susan Romanik (OFFICE BILLING MANAGER) |
| Authorized Official Contact | 4024969966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susannah Shell-phillips Pllc 1515 N 129th St Omaha NE 68154-1079 Ph: (402) 496-9966 | Susannah Shell-phillips Pllc 1101 4th St Fl 2 Sioux City IA 51101-1952 Ph: (712) 490-0006 |
| NPI Number | 1609590488 |
|---|---|
| Provider Enumeration Date | 09/27/2022 |
| Last Update Date | 09/27/2022 |
| Certification Date | 09/27/2022 |
| Medicare PECOS PAC ID | 8123497443 |
|---|---|
| Medicare Enrollment ID | O20221208001828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609590488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susannah L Shell-phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114015922 PECOS PAC ID: 1658564505 Enrollment ID: I20101022001241 |
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