| Center For Creative Human Performance, Llc | |
|
688 Knowles Ave Unit C Southampton PA 18966-4102 | |
| (215) 364-3722 | |
| (215) 968-9034 |
| Full Name | Center For Creative Human Performance, Llc |
|---|---|
| Speciality | Counselor |
| Location | 688 Knowles Ave, Southampton, Pennsylvania |
| Authorized Official Name and Position | Arathi R Rao (PRESIDENT) |
| Authorized Official Contact | 2153643722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Creative Human Performance, Llc 688 Knowles Ave Unit C Southampton PA 18966-4102 Ph: (215) 364-3722 | Center For Creative Human Performance, Llc 688 Knowles Ave Unit C Southampton PA 18966-4102 Ph: (215) 364-3722 |
| NPI Number | 1366593527 |
|---|---|
| Provider Enumeration Date | 01/15/2007 |
| Last Update Date | 02/12/2010 |
| Medicare PECOS PAC ID | 0547323735 |
|---|---|
| Medicare Enrollment ID | O20090114000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366593527 | NPI | - | NPPES |
| 819904000 | Other | PA | MAGELLAN MIS |
| 2579139000 | Other | PA | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Arathi R Rao |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982755062 PECOS PAC ID: 5294898482 Enrollment ID: I20090114000510 |
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