| Ever Blooming Therapy Services Llc | |
|
118 Joseph Ave Williamson WV 25661-3306 | |
| (304) 785-9815 | |
| Not Available |
| Full Name | Ever Blooming Therapy Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 118 Joseph Ave, Williamson, West Virginia |
| Authorized Official Name and Position | Carissa Sietsema (OWNER) |
| Authorized Official Contact | 3047850815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ever Blooming Therapy Services Llc Po Box 2274 Williamson WV 25661-2274 Ph: () - | Ever Blooming Therapy Services Llc 118 Joseph Ave Williamson WV 25661-3306 Ph: (304) 785-9815 |
| NPI Number | 1225735749 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 0244764108 |
|---|---|
| Medicare Enrollment ID | O20241114002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225735749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carissa Sietsema |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689229759 PECOS PAC ID: 8820459274 Enrollment ID: I20241115003691 |
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