Ms Kellie Renee Cousino, MSW,LSW | |
115 Aquinnah Dr, Pooler, GA 31322-8277 | |
(419) 217-2122 | |
Not Available |
Full Name | Ms Kellie Renee Cousino |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 115 Aquinnah Dr, Pooler, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295224897 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | I.2203507-SUPV (Ohio) | Primary |
Entity Name | Mindfully Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972702520 PECOS PAC ID: 3476606252 Enrollment ID: O20090727000253 |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220604000326 |
Mailing Address | Practice Location Address |
---|---|
Ms Kellie Renee Cousino, MSW,LSW 115 Aquinnah Dr, Pooler, GA 31322-8277 Ph: (419) 217-2122 | Ms Kellie Renee Cousino, MSW,LSW 115 Aquinnah Dr, Pooler, GA 31322-8277 Ph: (419) 217-2122 |
Andrea Lynette Keen-avery, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 184 Sonata Cir, Pooler, GA 31322 Phone: 443-986-6031 | |
Kathenia B Wright, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 105 Great Pine Ln, Pooler, GA 31322 Phone: 912-507-6368 | |
Darlene Davis, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 203 Claremont Way, Pooler, GA 31322 Phone: 804-920-9100 | |
Michelle Colon, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 103 S Godley Station Blvd Ste 101, Pooler, GA 31322 Phone: 912-988-3181 | |
Kelly Ann Osborne, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 412 Us Highway 80 Sw, Pooler, GA 31322 Phone: 912-712-2550 | |
Jessica Slash, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 208 Pine Forest Ln, Pooler, GA 31322 Phone: 912-704-2634 |