| Susan Langstraat Lcsw Llc | |
|
2151 County Road 228 Fulton MO 65251-3449 | |
| (573) 999-6207 | |
| Not Available |
| Full Name | Susan Langstraat Lcsw Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2151 County Road 228, Fulton, Missouri |
| Authorized Official Name and Position | Jessica Wisneski (BILLER) |
| Authorized Official Contact | 9139630958 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Langstraat Lcsw Llc 2151 County Road 228 Fulton MO 65251-3449 Ph: () - | Susan Langstraat Lcsw Llc 2151 County Road 228 Fulton MO 65251-3449 Ph: (573) 999-6207 |
| NPI Number | 1255056065 |
|---|---|
| Provider Enumeration Date | 10/05/2022 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 6002285608 |
|---|---|
| Medicare Enrollment ID | O20221202001739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255056065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Susan B Langstraat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902860042 PECOS PAC ID: 3476528027 Enrollment ID: I20040827000896 |
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