Mrs Fayetta Barron, LISW-S, LICDC | |
113 James Dr, Fairborn, OH 45324-5219 | |
(937) 241-9230 | |
Not Available |
Full Name | Mrs Fayetta Barron |
---|---|
Gender | Female |
Speciality | Social Worker |
Location | 113 James Dr, Fairborn, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487196788 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | I.1801329 (Ohio) | Secondary |
104100000X | Social Worker | S1501079 (Ohio) | Primary |
Entity Name | Divine Intervention Recovery Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912648528 PECOS PAC ID: 4789063694 Enrollment ID: O20220623002443 |
Mailing Address | Practice Location Address |
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Mrs Fayetta Barron, LISW-S, LICDC 302 W Main St, Fairborn, OH 45324-5037 Ph: (937) 281-4673 | Mrs Fayetta Barron, LISW-S, LICDC 113 James Dr, Fairborn, OH 45324-5219 Ph: (937) 241-9230 |
Renee J Jennings, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 680 E Dayton Yellow Springs Rd, Fairborn, OH 45324 Phone: 888-390-3800 Fax: 937-390-3804 | |
Julie L Mancy, MSW, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 188 W Hebble Ave, Fairborn, OH 45324 Phone: 937-754-5911 | |
Sarah Elizabeth Cadwallader, MSW, LISW-S Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 188 W Hebble Ave, Fairborn, OH 45324 Phone: 513-515-9642 | |
Ms. Connie S Williams, LISW-SUPV Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 302 W Main St, Fairborn, OH 45324 Phone: 937-281-4673 Fax: 937-318-1120 | |
Joshua Nordstrom, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2458 Antler Ct, Fairborn, OH 45324 Phone: 847-275-5674 | |
Tisha Mae Bates, LSW,MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 188 W Hebble Ave, Fairborn, OH 45324 Phone: 937-754-5911 |