| N/a | |
|
502 W 7th St Ste 100 Erie PA 16502-1333 | |
| (717) 756-6130 | |
| Not Available |
| Full Name | N/a |
|---|---|
| Speciality | Clinic/Center |
| Location | 502 W 7th St Ste 100, Erie, Pennsylvania |
| Authorized Official Name and Position | Alissa Jeanne Walsh (OWNER) |
| Authorized Official Contact | 2672237044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 502 W 7th St Ste 100 Erie PA 16502-1333 Ph: () - | N/a 502 W 7th St Ste 100 Erie PA 16502-1333 Ph: (717) 756-6130 |
| NPI Number | 1780379024 |
|---|---|
| Provider Enumeration Date | 04/11/2023 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 6305280041 |
|---|---|
| Medicare Enrollment ID | O20240221001133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780379024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Alissa Jeanne Walsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316367030 PECOS PAC ID: 7113361858 Enrollment ID: I20240221001364 |
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