| Systemic Supervision Training Center, Pllc | |
|
184 Finsbury St Durham NC 27703-8205 | |
| (919) 201-7122 | |
| Not Available |
| Full Name | Systemic Supervision Training Center, Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 184 Finsbury St, Durham, North Carolina |
| Authorized Official Name and Position | Tia Crooms (CEO) |
| Authorized Official Contact | 9192017122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Systemic Supervision Training Center, Pllc 184 Finsbury St Durham NC 27703-8205 Ph: (919) 201-7122 | Systemic Supervision Training Center, Pllc 184 Finsbury St Durham NC 27703-8205 Ph: (919) 201-7122 |
| NPI Number | 1528818143 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 03/26/2024 |
| Certification Date | 03/26/2024 |
| Medicare PECOS PAC ID | 3173041993 |
|---|---|
| Medicare Enrollment ID | O20250515002335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528818143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Tia Renee Crooms |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730334061 PECOS PAC ID: 4082132808 Enrollment ID: I20250515002514 |
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