| Lavender Moon Counseling And Healing | |
|
4-6 Water Street Amesbury MA 01913-2736 | |
| (978) 712-9698 | |
| (978) 373-0026 |
| Full Name | Lavender Moon Counseling And Healing |
|---|---|
| Speciality | Social Worker |
| Location | 4-6 Water Street, Amesbury, Massachusetts |
| Authorized Official Name and Position | Kaitlin Ann Burke (OWNER) |
| Authorized Official Contact | 9787129698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Moon Counseling And Healing 4-6 Water Street Amesbury MA 01913 Ph: (978) 712-9698 | Lavender Moon Counseling And Healing 4-6 Water Street Amesbury MA 01913-2736 Ph: (978) 712-9698 |
| NPI Number | 1699496687 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/06/2022 |
| Medicare PECOS PAC ID | 1355718909 |
|---|---|
| Medicare Enrollment ID | O20221110001715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699496687 | NPI | - | NPPES |
| 1366501173 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kaitlin Ann Burke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366501173 PECOS PAC ID: 3971875618 Enrollment ID: I20170816000634 |
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