| Awaken Insight | |
|
11-3784 2nd St Volcano HI 96785 | |
| (210) 527-8755 | |
| (210) 714-9757 |
| Full Name | Awaken Insight |
|---|---|
| Speciality | Social Worker |
| Location | 11-3784 2nd St, Volcano, Hawaii |
| Authorized Official Name and Position | Jesse Ryan Cardin (FOUNDER/OWNER/MANAGER/PROVIDER) |
| Authorized Official Contact | 2105278755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awaken Insight 2186 Jackson Keller Rd Pmb 3081 San Antonio TX 78213 Ph: (210) 527-8755 | Awaken Insight 11-3784 2nd St Volcano HI 96785 Ph: (210) 527-8755 |
| NPI Number | 1689216616 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 07/06/2023 |
| Certification Date | 06/27/2023 |
| Medicare PECOS PAC ID | 6800220880 |
|---|---|
| Medicare Enrollment ID | O20191227001889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689216616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jesse Ryan Cardin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801437314 PECOS PAC ID: 6002240082 Enrollment ID: I20191227001809 |
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