| Indigo Dove Lcsw Therapy Wellness Pc | |
|
1000 Atlantic Ave Baldwin NY 11510-4247 | |
| (516) 220-2244 | |
| Not Available |
| Full Name | Indigo Dove Lcsw Therapy Wellness Pc |
|---|---|
| Speciality | Social Worker |
| Location | 1000 Atlantic Ave, Baldwin, New York |
| Authorized Official Name and Position | Renae Tramonte (OWNER) |
| Authorized Official Contact | 5162202244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Dove Lcsw Therapy Wellness Pc 2829 Alder Rd Bellmore NY 11710-4700 Ph: () - | Indigo Dove Lcsw Therapy Wellness Pc 1000 Atlantic Ave Baldwin NY 11510-4247 Ph: (516) 220-2244 |
| NPI Number | 1922699610 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 07/15/2021 |
| Certification Date | 07/15/2021 |
| Medicare PECOS PAC ID | 2860807989 |
|---|---|
| Medicare Enrollment ID | O20210222002885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922699610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Renae A Tramonte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831401587 PECOS PAC ID: 3678562329 Enrollment ID: I20040508000341 |
| Provider Name | Elizabeth M Moshkovich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912249459 PECOS PAC ID: 2668695420 Enrollment ID: I20140523000183 |
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