| Evolve With Enas LLC | |
|
22 Orchard St Vernon CT 06066-3034 | |
| (860) 337-4007 | |
| Not Available |
| Full Name | Evolve With Enas LLC |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 22 Orchard St, Vernon, Connecticut |
| Authorized Official Name and Position | Enas Mohammad (CLINICIAN) |
| Authorized Official Contact | 8603374007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve With Enas LLC 22 Orchard St Vernon CT 06066-3034 Ph: (860) 337-4007 | Evolve With Enas LLC 22 Orchard St Vernon CT 06066-3034 Ph: (860) 337-4007 |
| NPI Number | 1669171120 |
|---|---|
| Provider Enumeration Date | 02/23/2023 |
| Last Update Date | 02/23/2023 |
| Certification Date | 02/23/2023 |
| Medicare PECOS PAC ID | 7618320771 |
|---|---|
| Medicare Enrollment ID | O20240125002013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669171120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (NU) | Primary |
| Provider Name | Enas Hameed Mohammad |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730515644 PECOS PAC ID: 8224481395 Enrollment ID: I20240125002270 |
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