| Theravada Therapy Llc | |
|
2504 W Main St Ste 2f Bozeman MT 59718-3966 | |
| (406) 595-3822 | |
| Not Available |
| Full Name | Theravada Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2504 W Main St Ste 2f, Bozeman, Montana |
| Authorized Official Name and Position | Mariah Rene Mcmanis (OWNER) |
| Authorized Official Contact | 4066007512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theravada Therapy Llc 2504 W Main St Ste 2f Bozeman MT 59718-3966 Ph: (406) 595-3822 | Theravada Therapy Llc 2504 W Main St Ste 2f Bozeman MT 59718-3966 Ph: (406) 595-3822 |
| NPI Number | 1275212151 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 10/13/2023 |
| Certification Date | 10/13/2023 |
| Medicare PECOS PAC ID | 0941664452 |
|---|---|
| Medicare Enrollment ID | O20230918001959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275212151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mariah R Mcmanis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902394927 PECOS PAC ID: 1153785654 Enrollment ID: I20230918001131 |
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