Mr George A Koussoglou, LCSW | |
10128 Hull Street Rd, Midlothian, VA 23112-3300 | |
(804) 276-5761 | |
(804) 745-3626 |
Full Name | Mr George A Koussoglou |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 10128 Hull Street Rd, Midlothian, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154494243 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 0904006093 (Virginia) | Primary |
Entity Name | Hanover County Board Of Supervisors |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104858653 PECOS PAC ID: 8527968742 Enrollment ID: O20040112000531 |
Mailing Address | Practice Location Address |
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Mr George A Koussoglou, LCSW 10128 Hull Street Rd, Midlothian, VA 23112-3300 Ph: (804) 276-5761 | Mr George A Koussoglou, LCSW 10128 Hull Street Rd, Midlothian, VA 23112-3300 Ph: (804) 276-5761 |
Dena Maria Wentz, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 13817 Village Mill Dr Ste R, Midlothian, VA 23114 Phone: 855-284-7483 Fax: 617-807-0958 | |
Kathleen S Levenston, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5001 W Village Green Dr Ste 205, Midlothian, VA 23112 Phone: 833-510-4357 | |
Jennifer Zito, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 600 Founders Bridge Blvd, Midlothian, VA 23113 Phone: 804-210-5448 | |
G. Tricia Baggett-phelps, M.S.W., L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10128 Hull Street Rd, Midlothian, VA 23112 Phone: 804-276-5761 Fax: 804-745-3626 | |
Ms. Sandra Goolsby, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13301 Midlothian Tpke Ste D, Midlothian, VA 23113 Phone: 804-464-1928 | |
Alicia Marie Mooradian, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2820 Waterford Lake Dr Ste 102, Midlothian, VA 23112 Phone: 804-658-4509 Fax: 804-658-4255 | |
Yesenia Villalta, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 14321 Winter Breeze Dr # 50, Midlothian, VA 23113 Phone: 571-317-1833 |