| Gentle Beacon, Llc | |
|
101 Foundry Dr Ste 1200 West Lafayette IN 47906-3446 | |
| (765) 299-6807 | |
| (765) 637-7402 |
| Full Name | Gentle Beacon, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 101 Foundry Dr Ste 1200, West Lafayette, Indiana |
| Authorized Official Name and Position | Christopher Hutcheson (STEWARD) |
| Authorized Official Contact | 7652996807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gentle Beacon, Llc 101 Foundry Dr Ste 1200 West Lafayette IN 47906-3446 Ph: (765) 299-6807 | Gentle Beacon, Llc 101 Foundry Dr Ste 1200 West Lafayette IN 47906-3446 Ph: (765) 299-6807 |
| NPI Number | 1871069344 |
|---|---|
| Provider Enumeration Date | 10/22/2018 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Medicare PECOS PAC ID | 4789928797 |
|---|---|
| Medicare Enrollment ID | O20181203001144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871069344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christopher C Hutcheson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154785897 PECOS PAC ID: 7618267642 Enrollment ID: I20160603001392 |
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