Jackie Marie Lelm, LICSW, MSW | |
1237 W Divide Ave, Ste 5, Bismarck, ND 58501-1208 | |
(701) 328-8843 | |
(701) 328-8900 |
Full Name | Jackie Marie Lelm |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1237 W Divide Ave, Bismarck, North Dakota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053354662 | NPI | - | NPPES |
N21924 | Other | RR MEDICARE | |
021924 | Other | BCBS OF ND PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 3132 (North Dakota) | Primary |
Entity Name | West Central Human Service Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649226713 PECOS PAC ID: 6002801107 Enrollment ID: O20040419000160 |
Mailing Address | Practice Location Address |
---|---|
Jackie Marie Lelm, LICSW, MSW 1237 W Divide Ave, Ste 5, Bismarck, ND 58501-1208 Ph: (701) 328-8843 | Jackie Marie Lelm, LICSW, MSW 1237 W Divide Ave, Ste 5, Bismarck, ND 58501-1208 Ph: (701) 328-8843 |
Brooke Leanne Joritz, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2700 State St Ste F, Bismarck, ND 58503 Phone: 701-895-4685 | |
Kellie Hoffman, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 619 Riverwood Dr Ste 105, Bismarck, ND 58504 Phone: 701-224-9751 | |
Darla J Stafford, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1800 E Interstate Ave Ste B, Bismarck, ND 58503 Phone: 701-323-6543 Fax: 701-323-5492 | |
Elisabeth Oldham, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1310 E Main Ave, Bismarck, ND 58501 Phone: 701-530-7195 | |
Debra M. Bosch, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1701 Burnt Boat Dr, Second Floor, Bismarck, ND 58503 Phone: 701-323-0924 Fax: 701-323-0935 | |
Nikki Marie Mundahl, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 315 N 11th St, Bismarck, ND 58501 Phone: 218-329-7097 |