| Tranquil Pines Counseling Llc | |
|
411 Kaila Ct Shamong NJ 08088-9688 | |
| (609) 401-2012 | |
| Not Available |
| Full Name | Tranquil Pines Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 411 Kaila Ct, Shamong, New Jersey |
| Authorized Official Name and Position | Kathleen Anne Lee (SOLE MBR) |
| Authorized Official Contact | 9082945898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tranquil Pines Counseling Llc Po Box 1117 Medford NJ 08055-6117 Ph: (908) 294-5898 | Tranquil Pines Counseling Llc 411 Kaila Ct Shamong NJ 08088-9688 Ph: (609) 401-2012 |
| NPI Number | 1114683596 |
|---|---|
| Provider Enumeration Date | 11/10/2021 |
| Last Update Date | 11/10/2021 |
| Certification Date | 11/10/2021 |
| Medicare PECOS PAC ID | 9032555883 |
|---|---|
| Medicare Enrollment ID | O20240314003183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114683596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kathleen Anne Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134559255 PECOS PAC ID: 6709183437 Enrollment ID: I20240314003095 |
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