| Keep Moving Forward Counseling & Consulting Llc | |
|
515 Windsor Park Dr Dayton OH 45459-4112 | |
| (937) 723-9881 | |
| (937) 723-9881 |
| Full Name | Keep Moving Forward Counseling & Consulting Llc |
|---|---|
| Speciality | Counselor |
| Location | 515 Windsor Park Dr, Dayton, Ohio |
| Authorized Official Name and Position | Brent Alan Bernard (OWNER) |
| Authorized Official Contact | 5133121532 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keep Moving Forward Counseling & Consulting Llc 515 Windsor Park Dr Dayton OH 45459-4112 Ph: (937) 723-9881 | Keep Moving Forward Counseling & Consulting Llc 515 Windsor Park Dr Dayton OH 45459-4112 Ph: (937) 723-9881 |
| NPI Number | 1174925762 |
|---|---|
| Provider Enumeration Date | 09/25/2014 |
| Last Update Date | 12/11/2023 |
| Certification Date | 12/11/2023 |
| Medicare PECOS PAC ID | 1658610936 |
|---|---|
| Medicare Enrollment ID | O20190304002195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174925762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | E3509 (Ohio) | Secondary |
| 101YM0800X | Counselor - Mental Health | E3509 (Ohio) | Primary |
| Provider Name | Shawnmari Marshall-kaiser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801341730 PECOS PAC ID: 0547510828 Enrollment ID: I20180906003324 |
| Provider Name | Brent Alan Bernard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700287901 PECOS PAC ID: 6103165485 Enrollment ID: I20240103000870 |
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