| Mind Renewal Therapy, Llc | |
|
3755 E State St Ste 6 Hermitage PA 16148-3410 | |
| (724) 734-6310 | |
| Not Available |
| Full Name | Mind Renewal Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3755 E State St Ste 6, Hermitage, Pennsylvania |
| Authorized Official Name and Position | Stephanie Marugg (PRESIDENT/THERAPIST) |
| Authorized Official Contact | 7247346310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Renewal Therapy, Llc 3755 E State St Ste 6 Hermitage PA 16148-3410 Ph: (724) 734-6310 | Mind Renewal Therapy, Llc 3755 E State St Ste 6 Hermitage PA 16148-3410 Ph: (724) 734-6310 |
| NPI Number | 1356012066 |
|---|---|
| Provider Enumeration Date | 09/22/2021 |
| Last Update Date | 09/22/2021 |
| Certification Date | 09/22/2021 |
| Medicare PECOS PAC ID | 6507255072 |
|---|---|
| Medicare Enrollment ID | O20211123000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356012066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Kay Marugg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285078303 PECOS PAC ID: 8325325988 Enrollment ID: I20170509000059 |
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