| Mycocun, Inc. | |
|
115 Red Oak Dr Lincoln University PA 19352-8939 | |
| (267) 908-4664 | |
| Not Available |
| Full Name | Mycocun, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 115 Red Oak Dr, Lincoln University, Pennsylvania |
| Authorized Official Name and Position | Jennifer Morgan Rakay (CLINICAL DIRECTOR & DEVELOPMENT) |
| Authorized Official Contact | 2679084664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mycocun, Inc. 115 Red Oak Dr Lincoln University PA 19352-8939 Ph: (672) 908-4664 | Mycocun, Inc. 115 Red Oak Dr Lincoln University PA 19352-8939 Ph: (267) 908-4664 |
| NPI Number | 1679100523 |
|---|---|
| Provider Enumeration Date | 03/23/2020 |
| Last Update Date | 03/23/2020 |
| Certification Date | 03/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679100523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
New London Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1016 State Road, Lincoln University, PA 19352 Phone: 813-252-0600 |