| Synchrony Therapeutic Services, Pllc | |
|
307 1st Ave E Ste 16 Kalispell MT 59901-4965 | |
| (406) 529-1104 | |
| Not Available |
| Full Name | Synchrony Therapeutic Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 307 1st Ave E Ste 16, Kalispell, Montana |
| Authorized Official Name and Position | Amy Gault (OWNER) |
| Authorized Official Contact | 4065291104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Synchrony Therapeutic Services, Pllc Po Box 446 Kalispell MT 59903-0446 Ph: (406) 529-1104 | Synchrony Therapeutic Services, Pllc 307 1st Ave E Ste 16 Kalispell MT 59901-4965 Ph: (406) 529-1104 |
| NPI Number | 1114636404 |
|---|---|
| Provider Enumeration Date | 11/16/2022 |
| Last Update Date | 11/16/2022 |
| Certification Date | 11/10/2022 |
| Medicare PECOS PAC ID | 5698145126 |
|---|---|
| Medicare Enrollment ID | O20221228000922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114636404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy Gault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376118661 PECOS PAC ID: 6507236031 Enrollment ID: I20221228000956 |
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