| Changing Times 2020 Vision Llc | |
|
2601 Anderson Ave Ste 202 Manhattan KS 66502-2809 | |
| (785) 422-3049 | |
| (785) 214-5018 |
| Full Name | Changing Times 2020 Vision Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2601 Anderson Ave Ste 202, Manhattan, Kansas |
| Authorized Official Name and Position | Kerry Clemetson (DIRECTOR OF BILLING) |
| Authorized Official Contact | 9134757713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Times 2020 Vision Llc 2601 Anderson Ave Ste 207 Manhattan KS 66502-2809 Ph: (785) 422-3049 | Changing Times 2020 Vision Llc 2601 Anderson Ave Ste 202 Manhattan KS 66502-2809 Ph: (785) 422-3049 |
| NPI Number | 1922648021 |
|---|---|
| Provider Enumeration Date | 01/07/2020 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Medicare PECOS PAC ID | 0941742043 |
|---|---|
| Medicare Enrollment ID | O20240604003769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922648021 | NPI | - | NPPES |
| 84-4065311 | Other | BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Sheri Lynn Wood |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316192727 PECOS PAC ID: 3476989013 Enrollment ID: I20240605000112 |
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