| The Counseling And Wellness House Llc | |
|
1539 E 100 N Kokomo IN 46901-3413 | |
| (765) 419-0164 | |
| (765) 457-6844 |
| Full Name | The Counseling And Wellness House Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1539 E 100 N, Kokomo, Indiana |
| Authorized Official Name and Position | Tara Lee Eytcheson (OWNER) |
| Authorized Official Contact | 7654190164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Counseling And Wellness House Llc 1539 E 100 N Kokomo IN 46901-3413 Ph: (765) 419-0164 | The Counseling And Wellness House Llc 1539 E 100 N Kokomo IN 46901-3413 Ph: (765) 419-0164 |
| NPI Number | 1619246204 |
|---|---|
| Provider Enumeration Date | 12/28/2011 |
| Last Update Date | 12/28/2011 |
| Medicare PECOS PAC ID | 0446417075 |
|---|---|
| Medicare Enrollment ID | O20120208000924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619246204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 34005437A (Indiana) | Primary |
| Provider Name | Tara L Eytcheson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275677270 PECOS PAC ID: 6002930807 Enrollment ID: I20100831000799 |
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