| Carrie Virginia Pate Therapy Center, Llc | |
|
2112 Bienville Blvd Suite L-1 Ocean Springs MS 39564-3052 | |
| (228) 990-8980 | |
| (228) 215-1721 |
| Full Name | Carrie Virginia Pate Therapy Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2112 Bienville Blvd, Ocean Springs, Mississippi |
| Authorized Official Name and Position | Carrie V Pate (OWNER AND PRACTITIONER) |
| Authorized Official Contact | 2289908980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carrie Virginia Pate Therapy Center, Llc 2112 Bienville Blvd Suite L-1 Ocean Springs MS 39564-3052 Ph: (228) 215-1744 | Carrie Virginia Pate Therapy Center, Llc 2112 Bienville Blvd Suite L-1 Ocean Springs MS 39564-3052 Ph: (228) 990-8980 |
| NPI Number | 1013374347 |
|---|---|
| Provider Enumeration Date | 01/17/2016 |
| Last Update Date | 05/01/2019 |
| Medicare PECOS PAC ID | 1355645516 |
|---|---|
| Medicare Enrollment ID | O20160209000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013374347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C6890 (Mississippi) | Primary |
| Provider Name | Carrie V Pate |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063724094 PECOS PAC ID: 8325285356 Enrollment ID: I20130513000125 |
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