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965 Green St Bellefonte PA 16823-2803 | |
| (814) 357-7755 | |
| (678) 882-3119 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 965 Green St, Bellefonte, Pennsylvania |
| Authorized Official Name and Position | Teresa Welch (OWNER) |
| Authorized Official Contact | 8147770505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
965 Green St Bellefonte PA 16823-2803 Ph: (814) 357-7755 | 965 Green St Bellefonte PA 16823-2803 Ph: (814) 357-7755 |
| NPI Number | 1427898154 |
|---|---|
| Provider Enumeration Date | 05/30/2024 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Medicare PECOS PAC ID | 2567900988 |
|---|---|
| Medicare Enrollment ID | O20240816001739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427898154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Teresa Welch |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1598721920 PECOS PAC ID: 5294273611 Enrollment ID: I20240821000102 |
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