| Peer Recovery & Therapy Services, Llc | |
|
10 Hale St Fl 4 Charleston WV 25301-2830 | |
| (304) 544-5453 | |
| (304) 841-0688 |
| Full Name | Peer Recovery & Therapy Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10 Hale St Fl 4, Charleston, West Virginia |
| Authorized Official Name and Position | Matthew Nelson (OWNER) |
| Authorized Official Contact | 3045511266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peer Recovery & Therapy Services, Llc 10 Hale St Fl 4 Charleston WV 25301-2830 Ph: (304) 544-5453 | Peer Recovery & Therapy Services, Llc 10 Hale St Fl 4 Charleston WV 25301-2830 Ph: (304) 544-5453 |
| NPI Number | 1568114262 |
|---|---|
| Provider Enumeration Date | 01/24/2022 |
| Last Update Date | 03/23/2022 |
| Certification Date | 03/23/2022 |
| Medicare PECOS PAC ID | 0244612083 |
|---|---|
| Medicare Enrollment ID | O20220727000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568114262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QR0800X | Clinic/center - Recovery Care | (* (Not Available)) | Secondary |
| Provider Name | Mary Katherine Lilly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285013888 PECOS PAC ID: 8820302565 Enrollment ID: I20150807015400 |
| Provider Name | Brittany Leanne Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740830504 PECOS PAC ID: 2961888326 Enrollment ID: I20221007002806 |
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