| Trauma Solutions Counseling | |
|
1174 E Graystone Way Ste 3 Salt Lake City UT 84106-2671 | |
| (385) 200-0786 | |
| (385) 415-0567 |
| Full Name | Trauma Solutions Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 1174 E Graystone Way Ste 3, Salt Lake City, Utah |
| Authorized Official Name and Position | Erick John Panike (OWNER) |
| Authorized Official Contact | 3852000786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma Solutions Counseling 1174 E Graystone Way Ste 3 Salt Lake City UT 84106-2671 Ph: (385) 200-0786 | Trauma Solutions Counseling 1174 E Graystone Way Ste 3 Salt Lake City UT 84106-2671 Ph: (385) 200-0786 |
| NPI Number | 1669068771 |
|---|---|
| Provider Enumeration Date | 12/14/2020 |
| Last Update Date | 12/28/2020 |
| Certification Date | 12/28/2020 |
| Medicare PECOS PAC ID | 2567875701 |
|---|---|
| Medicare Enrollment ID | O20210108000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669068771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Erick John Panike |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639684566 PECOS PAC ID: 4981943164 Enrollment ID: I20190306000522 |
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