| Hope Revisited Counseling Services Pllc | |
|
500 W Robert Bush Dr Ste 3 South Bend WA 98586-9075 | |
| (360) 209-3240 | |
| Not Available |
| Full Name | Hope Revisited Counseling Services Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 500 W Robert Bush Dr Ste 3, South Bend, Washington |
| Authorized Official Name and Position | Gina Renee Miles (OWNER) |
| Authorized Official Contact | 5098211035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Revisited Counseling Services Pllc Po Box 532 South Bend WA 98586-0532 Ph: (509) 821-1035 | Hope Revisited Counseling Services Pllc 500 W Robert Bush Dr Ste 3 South Bend WA 98586-9075 Ph: (360) 209-3240 |
| NPI Number | 1740877638 |
|---|---|
| Provider Enumeration Date | 12/24/2020 |
| Last Update Date | 12/24/2020 |
| Certification Date | 12/24/2020 |
| Medicare PECOS PAC ID | 2567876360 |
|---|---|
| Medicare Enrollment ID | O20210205000275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740877638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gina Renee Miles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124651419 PECOS PAC ID: 4284055658 Enrollment ID: I20200611000504 |
Ruby Behavioral Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Beach Street, South Bend, WA 98527 Phone: 360-219-6781 | |
Ruby Behavior Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Beach Street, South Bend, WA 98586 Phone: 360-219-6781 |