| Kingdom Counseling | |
|
325 W Taylor Ave Chandler IN 47610-9152 | |
| (812) 893-8450 | |
| Not Available |
| Full Name | Kingdom Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 325 W Taylor Ave, Chandler, Indiana |
| Authorized Official Name and Position | Tamia Fisher (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8123197083 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Counseling Po Box 384 Chandler IN 47610-0384 Ph: () - | Kingdom Counseling 325 W Taylor Ave Chandler IN 47610-9152 Ph: (812) 893-8450 |
| NPI Number | 1639955339 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 09/12/2023 |
| Certification Date | 09/12/2023 |
| Medicare PECOS PAC ID | 3476907189 |
|---|---|
| Medicare Enrollment ID | O20230929000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639955339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristina Lynn Groves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952773111 PECOS PAC ID: 6608118625 Enrollment ID: I20190423001901 |
Ascend Virtual Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 W Taylor Ave, Chandler, IN 47610 Phone: 812-484-6149 |