| Theresa Peterson-hadden, Llc | |
|
1371 W 6th St Erie PA 16505-2503 | |
| (814) 384-2423 | |
| (814) 725-0707 |
| Full Name | Theresa Peterson-hadden, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1371 W 6th St, Erie, Pennsylvania |
| Authorized Official Name and Position | Theresa Peterson-hadden (OWNER) |
| Authorized Official Contact | 8142183054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Peterson-hadden, Llc 1371 W 6th St Erie PA 16505-2503 Ph: (814) 384-2423 | Theresa Peterson-hadden, Llc 1371 W 6th St Erie PA 16505-2503 Ph: (814) 384-2423 |
| NPI Number | 1366801250 |
|---|---|
| Provider Enumeration Date | 02/19/2016 |
| Last Update Date | 02/23/2016 |
| Medicare PECOS PAC ID | 7113273178 |
|---|---|
| Medicare Enrollment ID | O20180705000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366801250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW015447 (Pennsylvania) | Primary |
| Provider Name | Theresa A Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760534416 PECOS PAC ID: 6204986797 Enrollment ID: I20141111000181 |
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