| Therapist Without Borders | |
|
210 E Main St Ste 304 Middletown NY 10940-4038 | |
| (845) 566-0286 | |
| Not Available |
| Full Name | Therapist Without Borders |
|---|---|
| Speciality | Social Worker |
| Location | 210 E Main St Ste 304, Middletown, New York |
| Authorized Official Name and Position | Kelly-ann Fairweather (OWNER) |
| Authorized Official Contact | 3475123636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapist Without Borders 27 Lenox Pl Middletown NY 10940-5526 Ph: (347) 512-3636 | Therapist Without Borders 210 E Main St Ste 304 Middletown NY 10940-4038 Ph: (845) 566-0286 |
| NPI Number | 1386155240 |
|---|---|
| Provider Enumeration Date | 10/18/2017 |
| Last Update Date | 10/18/2017 |
| Medicare PECOS PAC ID | 0648532721 |
|---|---|
| Medicare Enrollment ID | O20180330000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386155240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 083105 (New York) | Primary |
| Provider Name | Kelly-ann Monique Fairweather |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275829442 PECOS PAC ID: 1557623634 Enrollment ID: I20180330000268 |
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