| The Dalton House | |
|
702 E Ohio St Ste 11 Clinton MO 64735-2362 | |
| (660) 383-1696 | |
| Not Available |
| Full Name | The Dalton House |
|---|---|
| Speciality | Counselor |
| Location | 702 E Ohio St Ste 11, Clinton, Missouri |
| Authorized Official Name and Position | Lindy Johnson (OWNER) |
| Authorized Official Contact | 6603831696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dalton House Po Box 387 Clinton MO 64735-0387 Ph: () - | The Dalton House 702 E Ohio St Ste 11 Clinton MO 64735-2362 Ph: (660) 383-1696 |
| NPI Number | 1114798360 |
|---|---|
| Provider Enumeration Date | 01/15/2024 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Medicare PECOS PAC ID | 8123471133 |
|---|---|
| Medicare Enrollment ID | O20240125004201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114798360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lindy Anne Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609341593 PECOS PAC ID: 9032562046 Enrollment ID: I20240125004249 |
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