Susan Wilson, LCSW | |
360 Keen Street, Burkesville, KY 42717-1080 | |
(270) 864-1472 | |
(270) 864-1693 |
Full Name | Susan Wilson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 360 Keen Street, Burkesville, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699791475 | NPI | - | NPPES |
7100017280 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 1830 (Kentucky) | Primary |
Entity Name | Cumberland Family Medical Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306873500 PECOS PAC ID: 6305947789 Enrollment ID: O20120221000433 |
Mailing Address | Practice Location Address |
---|---|
Susan Wilson, LCSW Po Box 1080, Burkesville, KY 42717-1080 Ph: (270) 864-1472 | Susan Wilson, LCSW 360 Keen Street, Burkesville, KY 42717-1080 Ph: (270) 864-1472 |
Brenda C Tallent, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 299 Glasgow Road, Burkesville, KY 42717 Phone: 270-864-2511 | |
Joy Rashae Turner, MSSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 150 Glasgow Rd, Burkesville, KY 42717 Phone: 844-435-0900 Fax: 270-858-4607 | |
David E Rains, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 360 Keen Street, Burkesville, KY 42717 Phone: 270-864-2889 Fax: 270-864-2229 |