| Essence Of Life Therapeutic Services Llc | |
|
7 Demaret Ct Little Egg Harbor Twp NJ 08087-1808 | |
| (609) 857-1582 | |
| Not Available |
| Full Name | Essence Of Life Therapeutic Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 7 Demaret Ct, Little Egg Harbor Twp, New Jersey |
| Authorized Official Name and Position | Tatiana Negron (BILLING MANAGER) |
| Authorized Official Contact | 7327955519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essence Of Life Therapeutic Services Llc 7 Demaret Ct Little Egg Harbor Twp NJ 08087-1808 Ph: (609) 857-1582 | Essence Of Life Therapeutic Services Llc 7 Demaret Ct Little Egg Harbor Twp NJ 08087-1808 Ph: (609) 857-1582 |
| NPI Number | 1124806013 |
|---|---|
| Provider Enumeration Date | 09/20/2023 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 7012369440 |
|---|---|
| Medicare Enrollment ID | O20240122000832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124806013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lisa Fobian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316309792 PECOS PAC ID: 2264884717 Enrollment ID: I20241007003714 |
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