| Yellow Wood Talk Therapy, Llc | |
|
5256 Eider Ln Granite Falls NC 28630-8754 | |
| (828) 493-0759 | |
| (828) 212-0466 |
| Full Name | Yellow Wood Talk Therapy, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5256 Eider Ln, Granite Falls, North Carolina |
| Authorized Official Name and Position | Paul Anthony Mastrovito (CEO) |
| Authorized Official Contact | 8284930759 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yellow Wood Talk Therapy, Llc 5256 Eider Ln Granite Falls NC 28630-8754 Ph: (828) 493-0759 | Yellow Wood Talk Therapy, Llc 5256 Eider Ln Granite Falls NC 28630-8754 Ph: (828) 493-0759 |
| NPI Number | 1992154413 |
|---|---|
| Provider Enumeration Date | 06/06/2016 |
| Last Update Date | 09/28/2020 |
| Certification Date | 09/28/2020 |
| Medicare PECOS PAC ID | 3577855519 |
|---|---|
| Medicare Enrollment ID | O20160712000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992154413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C004644 (North Carolina) | Primary |
| Provider Name | Paul A Mastrovito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396827481 PECOS PAC ID: 0042236689 Enrollment ID: I20051021000796 |
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