| Full Bloom Counseling Llc | |
|
8199 Robin Hill Rd Ste C Newburgh IN 47630-3086 | |
| (812) 215-5584 | |
| (812) 215-5884 |
| Full Name | Full Bloom Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8199 Robin Hill Rd Ste C, Newburgh, Indiana |
| Authorized Official Name and Position | Sarah Godwin (OWNER) |
| Authorized Official Contact | 8122023982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Bloom Counseling Llc 8199 Robin Hill Rd Ste C Newburgh IN 47630-3086 Ph: (812) 215-5584 | Full Bloom Counseling Llc 8199 Robin Hill Rd Ste C Newburgh IN 47630-3086 Ph: (812) 215-5584 |
| NPI Number | 1285323303 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 2567812167 |
|---|---|
| Medicare Enrollment ID | O20231222000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285323303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa Deanne Patterson-wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013143239 PECOS PAC ID: 7517228075 Enrollment ID: I20180223001301 |
| Provider Name | Sarah M Godwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265615991 PECOS PAC ID: 2466849880 Enrollment ID: I20220503001338 |
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