| The Eden Center For Integrative Care | |
|
84 Broad St Glens Falls NY 12801-4386 | |
| (518) 636-5284 | |
| Not Available |
| Full Name | The Eden Center For Integrative Care |
|---|---|
| Speciality | Psychologist |
| Location | 84 Broad St, Glens Falls, New York |
| Authorized Official Name and Position | Chelsea Davis (OFFICE MANAGER) |
| Authorized Official Contact | 5187912856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Eden Center For Integrative Care 84 Broad St Ste 2 Glens Falls NY 12801-4381 Ph: (518) 636-5284 | The Eden Center For Integrative Care 84 Broad St Glens Falls NY 12801-4386 Ph: (518) 636-5284 |
| NPI Number | 1457027526 |
|---|---|
| Provider Enumeration Date | 08/19/2021 |
| Last Update Date | 08/19/2021 |
| Certification Date | 08/19/2021 |
| Medicare PECOS PAC ID | 0749634640 |
|---|---|
| Medicare Enrollment ID | O20230926003857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457027526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Janet L Yager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104133206 PECOS PAC ID: 5597937334 Enrollment ID: I20111020000404 |
| Provider Name | Shannon James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053898908 PECOS PAC ID: 3173869898 Enrollment ID: I20190116002205 |
| Provider Name | Julio A Riascos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801179668 PECOS PAC ID: 0446517676 Enrollment ID: I20200117001675 |
| Provider Name | Daniel Breeyear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922620178 PECOS PAC ID: 8921411703 Enrollment ID: I20210115002215 |
| Provider Name | Vanessa R Ives |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780159392 PECOS PAC ID: 1850782798 Enrollment ID: I20220103001115 |
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