| Inner Journey Counseling Pc | |
|
711 N Beaver St Flagstaff AZ 86001-3103 | |
| (928) 380-6130 | |
| Not Available |
| Full Name | Inner Journey Counseling Pc |
|---|---|
| Speciality | Social Worker |
| Location | 711 N Beaver St, Flagstaff, Arizona |
| Authorized Official Name and Position | Ron Paul (PRESIDENT) |
| Authorized Official Contact | 9283806130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Journey Counseling Pc 711 N Beaver St Flagstaff AZ 86001-3103 Ph: (928) 380-6130 | Inner Journey Counseling Pc 711 N Beaver St Flagstaff AZ 86001-3103 Ph: (928) 380-6130 |
| NPI Number | 1659702405 |
|---|---|
| Provider Enumeration Date | 12/04/2013 |
| Last Update Date | 12/04/2013 |
| Medicare PECOS PAC ID | 8123259421 |
|---|---|
| Medicare Enrollment ID | O20140331001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659702405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-13675 (Arizona) | Primary |
| Provider Name | Ronald E Paul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639414964 PECOS PAC ID: 4981846813 Enrollment ID: I20130806000444 |
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