Dawn Boughton, | |
236 Simpson Ave, Elkhart, IN 46516-4666 | |
(574) 293-0052 | |
Not Available |
Full Name | Dawn Boughton |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 236 Simpson Ave, Elkhart, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578935235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 34008244A (Indiana) | Primary |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
Entity Name | The Otis R Bowen Center For Human Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639172810 PECOS PAC ID: 7618950965 Enrollment ID: O20050404000853 |
Mailing Address | Practice Location Address |
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Dawn Boughton, 236 Simpson Ave, Elkhart, IN 46516-4666 Ph: (574) 293-0052 | Dawn Boughton, 236 Simpson Ave, Elkhart, IN 46516-4666 Ph: (574) 293-0052 |
Steven D Bright, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 | |
Ronald L Shoemaker, LSCW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 | |
Angela Gingerich, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1004 Parkway Ave, Suite D, Elkhart, IN 46516 Phone: 574-293-0005 | |
Patricia L Carnegie, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 | |
Gwendolyn K Preheim-bartel, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 | |
Mr. Larry L Rupp, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3040a Windsor Ct, Elkhart, IN 46514 Phone: 574-262-1088 Fax: 574-262-9516 | |
Melissa Alvarez, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2710 Turner St Apt A, Elkhart, IN 46517 Phone: 574-747-7024 |