| Marcos Moreno Pllc | |
|
2596 N Stokesberry Pl Ste 180 Meridian ID 83646-6282 | |
| (208) 391-4841 | |
| (208) 391-4966 |
| Full Name | Marcos Moreno Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2596 N Stokesberry Pl Ste 180, Meridian, Idaho |
| Authorized Official Name and Position | Marcos Moreno (OWNER/LCSW) |
| Authorized Official Contact | 2083914841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcos Moreno Pllc 5154 N Buckboard Pl Boise ID 83713-1871 Ph: (208) 995-3664 | Marcos Moreno Pllc 2596 N Stokesberry Pl Ste 180 Meridian ID 83646-6282 Ph: (208) 391-4841 |
| NPI Number | 1952935504 |
|---|---|
| Provider Enumeration Date | 02/22/2020 |
| Last Update Date | 02/22/2020 |
| Certification Date | 02/22/2020 |
| Medicare PECOS PAC ID | 4486082864 |
|---|---|
| Medicare Enrollment ID | O20200318000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952935504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marcos Moreno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528491834 PECOS PAC ID: 7113210998 Enrollment ID: I20160802000064 |
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