| Kairos Psychotherapy Llc | |
|
4 Castle St Apt 10 Great Barrington MA 01230-2404 | |
| (413) 644-6473 | |
| Not Available |
| Full Name | Kairos Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4 Castle St Apt 10, Great Barrington, Massachusetts |
| Authorized Official Name and Position | Lisa Solomon (OWNER) |
| Authorized Official Contact | 4136446473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kairos Psychotherapy Llc Po Box 826 Great Barrington MA 01230-0826 Ph: (413) 644-6473 | Kairos Psychotherapy Llc 4 Castle St Apt 10 Great Barrington MA 01230-2404 Ph: (413) 644-6473 |
| NPI Number | 1073116075 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 11/20/2020 |
| Certification Date | 11/20/2020 |
| Medicare PECOS PAC ID | 1355754961 |
|---|---|
| Medicare Enrollment ID | O20201228001452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073116075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lisa Solomon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891000675 PECOS PAC ID: 0547565210 Enrollment ID: I20160218001367 |
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