| Seaside Psychotherapy Llc | |
|
791 Se Fidalgo Ave Ste 101 Oak Harbor WA 98277-5505 | |
| (360) 485-0980 | |
| Not Available |
| Full Name | Seaside Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 791 Se Fidalgo Ave Ste 101, Oak Harbor, Washington |
| Authorized Official Name and Position | Charlotte Myers (LCSW/OWNER) |
| Authorized Official Contact | 2084043247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seaside Psychotherapy Llc 851 Park Ave Oak Harbor WA 98277-8256 Ph: (360) 485-0980 | Seaside Psychotherapy Llc 791 Se Fidalgo Ave Ste 101 Oak Harbor WA 98277-5505 Ph: (360) 485-0980 |
| NPI Number | 1225549983 |
|---|---|
| Provider Enumeration Date | 10/20/2017 |
| Last Update Date | 10/20/2017 |
| Medicare PECOS PAC ID | 5890053029 |
|---|---|
| Medicare Enrollment ID | O20171218001428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225549983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 60512881 (Washington) | Primary |
| Provider Name | Charlotte M Myers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144505553 PECOS PAC ID: 3274803622 Enrollment ID: I20170718003664 |
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