| Therese White Msw Lcsw Therapeutic Services Llc | |
|
124 Main St. Suite 305 Dillon CO 80435 | |
| (630) 508-4545 | |
| Not Available |
| Full Name | Therese White Msw Lcsw Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 124 Main St. Suite 305, Dillon, Colorado |
| Authorized Official Name and Position | Therese White (LCSW) |
| Authorized Official Contact | 6305084545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therese White Msw Lcsw Therapeutic Services Llc Po Box 1292 Silverthorne CO 80498-1292 Ph: () - | Therese White Msw Lcsw Therapeutic Services Llc 124 Main St. Suite 305 Dillon CO 80435 Ph: (630) 508-4545 |
| NPI Number | 1861029043 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 03/26/2020 |
| Certification Date | 03/26/2020 |
| Medicare PECOS PAC ID | 8123449006 |
|---|---|
| Medicare Enrollment ID | O20200601002464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861029043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Therese M White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295087765 PECOS PAC ID: 3375964265 Enrollment ID: I20200601002870 |
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