| Mountain Therapy Collaborative | |
|
870 Emerald Bay Rd Ste 303 South Lake Tahoe CA 96150-9400 | |
| (415) 806-0275 | |
| (530) 600-0063 |
| Full Name | Mountain Therapy Collaborative |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 870 Emerald Bay Rd Ste 303, South Lake Tahoe, California |
| Authorized Official Name and Position | Matthew Wong (OWNER) |
| Authorized Official Contact | 4158060275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Therapy Collaborative 870 Emerald Bay Rd Ste 303 South Lake Tahoe CA 96150-9400 Ph: (415) 806-0275 | Mountain Therapy Collaborative 870 Emerald Bay Rd Ste 303 South Lake Tahoe CA 96150-9400 Ph: (415) 806-0275 |
| NPI Number | 1053825505 |
|---|---|
| Provider Enumeration Date | 11/20/2017 |
| Last Update Date | 11/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053825505 | NPI | - | NPPES |
| 1598157117 | Medicaid | CA | |
| 1619169653 | Medicaid | NC |
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