Ms Shawandalyn Latrelle Cooley, LCSW | |
825 Gum Branch Rd, Suite 133, Jacksonville, NC 28540-6298 | |
(910) 346-6726 | |
(910) 346-8285 |
Full Name | Ms Shawandalyn Latrelle Cooley |
---|---|
Gender | Female |
Speciality | Clinical Social Worker |
Experience | 23 Years |
Location | 825 Gum Branch Rd, Jacksonville, North Carolina |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376608653 | NPI | - | NPPES |
8300057B | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | C004961 (North Carolina) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Axis Healthcare Group | 1254409550 | 47 |
Axis Healthcare Group | 1254409550 | 47 |
Entity Name | Axis Healthcare Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326295098 PECOS PAC ID: 1254409550 Enrollment ID: O20120919000403 |
Mailing Address | Practice Location Address |
---|---|
Ms Shawandalyn Latrelle Cooley, LCSW 8040 Georgia Ave Ste 170, Silver Spring, MD 20910-4959 Ph: (202) 360-4787 | Ms Shawandalyn Latrelle Cooley, LCSW 825 Gum Branch Rd, Suite 133, Jacksonville, NC 28540-6298 Ph: (910) 346-6726 |
Jessica Smith, MSW,LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 215 Memorial Dr, Jacksonville, NC 28546 Phone: 910-353-5118 | |
Amanda Ashley Manning, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Tarpon Trl, Jacksonville, NC 28546 Phone: 910-938-1114 Fax: 910-938-1118 | |
Elise Cowart, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 445 Western Blvd Ste Q, Jacksonville, NC 28546 Phone: 910-858-5848 | |
Portia Adams, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 110 Branchwood Dr Ste B, Jacksonville, NC 28546 Phone: 910-938-9833 | |
Ms. Tatianna Brooks, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 231 New Bridge St, Jacksonville, NC 28540 Phone: 910-915-9155 Fax: 910-939-5484 | |
Nicole Marie Polidoro, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Tarpon Trl, Jacksonville, NC 28546 Phone: 910-938-1114 Fax: 910-938-1118 | |
Shirby Durant, LCSWA, LCASA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 231 Memorial Dr, Jacksonville, NC 28546 Phone: 910-353-5354 |