| Therapeutic Impressions Llc | |
|
104 Pilgrim Village Dr Ste 300 Cumming GA 30040-9232 | |
| (678) 595-2020 | |
| Not Available |
| Full Name | Therapeutic Impressions Llc |
|---|---|
| Speciality | Social Worker |
| Location | 104 Pilgrim Village Dr Ste 300, Cumming, Georgia |
| Authorized Official Name and Position | Jessica B Sheridan (OWNER, THERAPIST) |
| Authorized Official Contact | 6785952020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Impressions Llc 104 Pilgrim Village Dr Ste 300 Cumming GA 30040-9232 Ph: (678) 595-2020 | Therapeutic Impressions Llc 104 Pilgrim Village Dr Ste 300 Cumming GA 30040-9232 Ph: (678) 595-2020 |
| NPI Number | 1134661945 |
|---|---|
| Provider Enumeration Date | 11/09/2016 |
| Last Update Date | 11/09/2016 |
| Medicare PECOS PAC ID | 1557646395 |
|---|---|
| Medicare Enrollment ID | O20170317002131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134661945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 005777 (Georgia) | Primary |
| Provider Name | Jessica Sheridan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164822623 PECOS PAC ID: 7618261306 Enrollment ID: I20160803000647 |
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