| Wentworth Mft Pllc | |
|
313 Yelm Ave W Yelm WA 98597-8036 | |
| (360) 960-0441 | |
| Not Available |
| Full Name | Wentworth Mft Pllc |
|---|---|
| Speciality | Counselor |
| Location | 313 Yelm Ave W, Yelm, Washington |
| Authorized Official Name and Position | Jennifer Wentworth (THERAPIST/OWNER) |
| Authorized Official Contact | 3609600441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wentworth Mft Pllc 313 Yelm Ave W Yelm WA 98597-8036 Ph: (360) 960-0441 | Wentworth Mft Pllc 313 Yelm Ave W Yelm WA 98597-8036 Ph: (360) 960-0441 |
| NPI Number | 1518674993 |
|---|---|
| Provider Enumeration Date | 11/03/2022 |
| Last Update Date | 11/03/2022 |
| Certification Date | 11/03/2022 |
| Medicare PECOS PAC ID | 5496292369 |
|---|---|
| Medicare Enrollment ID | O20240809000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518674993 | NPI | - | NPPES |
| Provider Name | Jennifer Elaine Wentworth |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669759155 PECOS PAC ID: 6305383274 Enrollment ID: I20240809000272 |
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