Gregory Maynard, LCADC | |
104 S Front Ave, Prestonsburg, KY 41653-1614 | |
(606) 886-8572 | |
(606) 886-4433 |
Full Name | Gregory Maynard |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 104 S Front Ave, Prestonsburg, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366853178 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 258580 (Kentucky) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 251975 (Kentucky) | Secondary |
Entity Name | Isaiah House Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396086559 PECOS PAC ID: 7113262163 Enrollment ID: O20181219000602 |
Mailing Address | Practice Location Address |
---|---|
Gregory Maynard, LCADC 104 S Front Ave, Prestonsburg, KY 41653-1614 Ph: (606) 886-8572 | Gregory Maynard, LCADC 104 S Front Ave, Prestonsburg, KY 41653-1614 Ph: (606) 886-8572 |
Virgil Ryan Butcher, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 | |
Whitney Litteral, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 | |
Robin Bilan, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 | |
Yamiley Coleman, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 | |
Jenny Leigh Moore, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 | |
Bonnie B. Hale, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 | |
Whitney King, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 |