| Swiftwater Counseling | |
|
116 N Oakes Ave Ste A2 Cle Elum WA 98922-1273 | |
| (509) 961-0547 | |
| Not Available |
| Full Name | Swiftwater Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 116 N Oakes Ave Ste A2, Cle Elum, Washington |
| Authorized Official Name and Position | Carly Mankus (PROVIDER/OWNER) |
| Authorized Official Contact | 5099610547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Swiftwater Counseling Po Box 346 Naches WA 98937-0346 Ph: (509) 961-0547 | Swiftwater Counseling 116 N Oakes Ave Ste A2 Cle Elum WA 98922-1273 Ph: (509) 961-0547 |
| NPI Number | 1548887383 |
|---|---|
| Provider Enumeration Date | 06/27/2020 |
| Last Update Date | 10/13/2020 |
| Certification Date | 10/13/2020 |
| Medicare PECOS PAC ID | 6406266279 |
|---|---|
| Medicare Enrollment ID | O20201105002173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548887383 | NPI | - | NPPES |
| 1770863987 | Other | WA | INDIVIDUAL NPI |
| 1548887383 | Medicaid | WA | |
| 2163968 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Carly A Mankus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770863987 PECOS PAC ID: 8820328073 Enrollment ID: I20191001002115 |