| Life And Trauma Survivor Center Llc | |
|
402 Wall St Ste 42 Valparaiso IN 46383-2572 | |
| (219) 510-8043 | |
| (219) 241-8044 |
| Full Name | Life And Trauma Survivor Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 402 Wall St Ste 42, Valparaiso, Indiana |
| Authorized Official Name and Position | Sherrie Ann Shivok (OWNER) |
| Authorized Official Contact | 2192410212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life And Trauma Survivor Center Llc 402 Wall St Ste 42 Valparaiso IN 46383-2572 Ph: (219) 510-8043 | Life And Trauma Survivor Center Llc 402 Wall St Ste 42 Valparaiso IN 46383-2572 Ph: (219) 510-8043 |
| NPI Number | 1619432119 |
|---|---|
| Provider Enumeration Date | 02/08/2019 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Medicare PECOS PAC ID | 7517487382 |
|---|---|
| Medicare Enrollment ID | O20250224001748 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619432119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sherrie Shivok |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851865281 PECOS PAC ID: 8426578295 Enrollment ID: I20250224002933 |
Zachary Burns, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 Morgan Blvd, Valparaiso, IN 46383 Phone: 219-916-2521 Fax: 219-462-4741 | |
Hart Behavior Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 731 W Marrew Pl, Valparaiso, IN 46383 Phone: 219-476-5809 | |
Comprehensive Neurology Care, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Wall St Ste 104, Valparaiso, IN 46383 Phone: 219-531-6571 | |
Neurology Associates Of Northwest Indiana, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1551 Sturdy Rd, Valparaiso, IN 46383 Phone: 219-548-0235 Fax: 219-548-8366 | |
Gerald Lewis Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3000 Murvihill Rd, Valparaiso, IN 46383 Phone: 219-286-3907 Fax: 219-286-3911 | |
New Beginnings Counseling, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 793-1 Juniper Rd, Valparaiso, IN 46385 Phone: 219-203-2343 | |
Nzinga Mind And Heart Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Washington St Ste 300, Valparaiso, IN 46383 Phone: 866-220-0238 Fax: 866-220-0238 |