| Caretide Counseling, Llc | |
|
4465 Martin Rd Ste A Cumming GA 30028-3952 | |
| (770) 530-4218 | |
| Not Available |
| Full Name | Caretide Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4465 Martin Rd Ste A, Cumming, Georgia |
| Authorized Official Name and Position | Jennifer Carson (OWNER) |
| Authorized Official Contact | 7705304218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caretide Counseling, Llc 4465 Martin Rd Ste A Cumming GA 30028-3952 Ph: (770) 530-4218 | Caretide Counseling, Llc 4465 Martin Rd Ste A Cumming GA 30028-3952 Ph: (770) 530-4218 |
| NPI Number | 1720741531 |
|---|---|
| Provider Enumeration Date | 10/19/2021 |
| Last Update Date | 10/19/2021 |
| Certification Date | 10/19/2021 |
| Medicare PECOS PAC ID | 1759774615 |
|---|---|
| Medicare Enrollment ID | O20220217000850 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720741531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michael R Kenney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952552796 PECOS PAC ID: 7911262290 Enrollment ID: I20180607003133 |
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