Software Engineer

Location:

Posted:

September 07, 2024

Kym E. Sites, M.S.

MFT MF*****

San Francisco, CA. 94115

Date: April 3, 2024

Name: Linda Woo D.O.B.: 10/27/1966

Service Provided: Individual Psychotherapy

Dates of Service: March 14, 21, 2024

Units Billed: 1 unit each visit

Place of Service: 02: Telemental Health

Fee per hour: $200.00

Past Balance: None

Total Due: $400.00

Diagnosis: Major Depressive Disorder, Recurrent, Moderate: (F33.1)

CPT Code: 90837

Tax I.D. #***-**-**** NPI# 140********