Bertha Jackson, | |
6224 Shenfield Ln, Union City, GA 30291-7117 | |
(470) 236-8813 | |
Not Available |
Full Name | Bertha Jackson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 6224 Shenfield Ln, Union City, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720852536 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CSW008840 (Georgia) | Primary |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220315000829 |
Mailing Address | Practice Location Address |
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Bertha Jackson, 6224 Shenfield Ln, Union City, GA 30291-7117 Ph: (470) 236-8813 | Bertha Jackson, 6224 Shenfield Ln, Union City, GA 30291-7117 Ph: (470) 236-8813 |
Shae-dee Reigns, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3835 Cypress Pointe Dr, Union City, GA 30291 Phone: 347-770-7423 | |
Mrs. Melanie L. Ponder-wright, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4405 Mall Blvd, Union City, GA 30291 Phone: 770-892-3200 | |
Ms. Charmaine Veronica Mattocks, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 7413 Gossamer St, Union City, GA 30291 Phone: 404-664-2381 | |
Beatrice Berry, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4500 Shannon Blvd Apt 6b, Union City, GA 30291 Phone: 770-774-3493 | |
Mrs. Retina Deon Dawson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5100 Alexander Ave, Union City, GA 30291 Phone: 404-428-8038 | |
Dr. Donnetta Shante Washington, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4550 Jonesboro Rd Ste A2-208, Union City, GA 30291 Phone: 205-575-9303 |