| Mountain Metta Psychiatry, Llc | |
|
1785 E 1450 S Ste 360 Clearfield UT 84015-2354 | |
| (801) 396-0401 | |
| (801) 406-1062 |
| Full Name | Mountain Metta Psychiatry, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1785 E 1450 S Ste 360, Clearfield, Utah |
| Authorized Official Name and Position | Amber Mackey Wilson (PSYCHIATRIST/OWNER) |
| Authorized Official Contact | 8013960401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Metta Psychiatry, Llc 1785 E 1450 S Ste 360 Clearfield UT 84015-2354 Ph: (801) 396-0401 | Mountain Metta Psychiatry, Llc 1785 E 1450 S Ste 360 Clearfield UT 84015-2354 Ph: (801) 396-0401 |
| NPI Number | 1821662750 |
|---|---|
| Provider Enumeration Date | 05/15/2021 |
| Last Update Date | 09/07/2021 |
| Certification Date | 05/17/2021 |
| Medicare PECOS PAC ID | 6002217635 |
|---|---|
| Medicare Enrollment ID | O20210702000248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821662750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Amber Nicole Mackey Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538506472 PECOS PAC ID: 9032337621 Enrollment ID: I20210702000335 |
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