| United Therapist Group Usa, Llc | |
|
2101 N Federal Hwy Ste D110 Pompano Beach FL 33062-1024 | |
| (954) 253-2720 | |
| Not Available |
| Full Name | United Therapist Group Usa, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2101 N Federal Hwy Ste D110, Pompano Beach, Florida |
| Authorized Official Name and Position | Katia Tikhonravova (LMFT) |
| Authorized Official Contact | 9542532720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| United Therapist Group Usa, Llc 812 S Riverside Dr Pompano Beach FL 33062-6200 Ph: (954) 253-2720 | United Therapist Group Usa, Llc 2101 N Federal Hwy Ste D110 Pompano Beach FL 33062-1024 Ph: (954) 253-2720 |
| NPI Number | 1881309250 |
|---|---|
| Provider Enumeration Date | 01/19/2023 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Medicare PECOS PAC ID | 8426593997 |
|---|---|
| Medicare Enrollment ID | O20240709004494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881309250 | NPI | - | NPPES |
| MT3336 | Other | FL | BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Katia Tikhonravova |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730895855 PECOS PAC ID: 0244775716 Enrollment ID: I20240709004606 |
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