| Cultivating Wellness | |
|
227 E Sunshine St Springfield MO 65807-2652 | |
| (417) 709-4909 | |
| (417) 709-4909 |
| Full Name | Cultivating Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 227 E Sunshine St, Springfield, Missouri |
| Authorized Official Name and Position | Angela K Coulter (THERAPIST) |
| Authorized Official Contact | 4177665566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cultivating Wellness 227 E Sunshine St Ste 112 Springfield MO 65807-2630 Ph: (417) 709-4909 | Cultivating Wellness 227 E Sunshine St Springfield MO 65807-2652 Ph: (417) 709-4909 |
| NPI Number | 1275199804 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 05/20/2019 |
| Medicare PECOS PAC ID | 1355670860 |
|---|---|
| Medicare Enrollment ID | O20190909003566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275199804 | NPI | - | NPPES |
| 1235135153 | Other | MO | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Angela K Coulter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235135153 PECOS PAC ID: 1153542964 Enrollment ID: I20141021000235 |
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