| V. Blakeman Psychotherapy Llc | |
|
2 Clerico Ln Ste 103 Hillsborough NJ 08844-1620 | |
| (843) 424-3465 | |
| Not Available |
| Full Name | V. Blakeman Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2 Clerico Ln Ste 103, Hillsborough, New Jersey |
| Authorized Official Name and Position | Virginia Blakeman (OWNER) |
| Authorized Official Contact | 8434243465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| V. Blakeman Psychotherapy Llc Po Box 5705 Hillsborough NJ 08844-5705 Ph: (843) 424-3465 | V. Blakeman Psychotherapy Llc 2 Clerico Ln Ste 103 Hillsborough NJ 08844-1620 Ph: (843) 424-3465 |
| NPI Number | 1932613932 |
|---|---|
| Provider Enumeration Date | 11/29/2017 |
| Last Update Date | 11/28/2022 |
| Certification Date | 11/28/2022 |
| Medicare PECOS PAC ID | 0547522351 |
|---|---|
| Medicare Enrollment ID | O20180314001696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932613932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05744600 (New Jersey) | Primary |
| Provider Name | Virginia D Blakeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902200736 PECOS PAC ID: 3476829052 Enrollment ID: I20171026000853 |
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