Teena Mabry, LCSW | |
7509 White Oak Ave, Hammond, IN 46324-3140 | |
(708) 261-7622 | |
Not Available |
Full Name | Teena Mabry |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 7509 White Oak Ave, Hammond, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598446767 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.024752 (Illinois) | Primary |
Entity Name | Vitae Health Of Illinois Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174013452 PECOS PAC ID: 2365798410 Enrollment ID: O20180703002838 |
Mailing Address | Practice Location Address |
---|---|
Teena Mabry, LCSW 7509 White Oak Ave, Hammond, IN 46324-3140 Ph: (708) 261-7622 | Teena Mabry, LCSW 7509 White Oak Ave, Hammond, IN 46324-3140 Ph: (708) 261-7622 |
Mr. Daniel M. Knaver, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6919 Indianapolis Blvd, Hammond, IN 46324 Phone: 219-844-4883 Fax: 219-844-4885 | |
Veronica Booker, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2714 169th St, Hammond, IN 46323 Phone: 219-554-0688 Fax: 219-554-1773 | |
Damonica Colleen Bryant, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5900 Hohman Ave, Hammond, IN 46320 Phone: 219-931-0427 Fax: 219-937-5808 | |
Keith Wygle, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5900 Hohman Ave, Hammond, IN 46320 Phone: 219-931-0427 Fax: 219-931-0427 | |
Amy Ann Kathryn Burian, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5900 Hohman Ave, Hammond, IN 46320 Phone: 219-931-0427 Fax: 219-931-0427 | |
Cheryl Ann Sopo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6919 Indianapolis Blvd, Hammond, IN 46324 Phone: 219-844-4883 Fax: 219-844-4885 |