| Healing Space Of Athens Llc | |
|
1 Huntington Rd Ste 703 Athens GA 30606-7214 | |
| (706) 425-8900 | |
| Not Available |
| Full Name | Healing Space Of Athens Llc |
|---|---|
| Speciality | Counselor |
| Location | 1 Huntington Rd Ste 703, Athens, Georgia |
| Authorized Official Name and Position | Aline Robolin (COUNSELOR) |
| Authorized Official Contact | 7064258900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Space Of Athens Llc 1 Huntington Rd Ste 703 Athens GA 30606-7214 Ph: (706) 425-8900 | Healing Space Of Athens Llc 1 Huntington Rd Ste 703 Athens GA 30606-7214 Ph: (706) 425-8900 |
| NPI Number | 1043051501 |
|---|---|
| Provider Enumeration Date | 06/06/2024 |
| Last Update Date | 10/24/2024 |
| Certification Date | 10/24/2024 |
| Medicare PECOS PAC ID | 0143669168 |
|---|---|
| Medicare Enrollment ID | O20241023004749 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043051501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Aline Robolin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770631053 PECOS PAC ID: 1052750072 Enrollment ID: I20241101001229 |
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