Cassandra Eden Untiedt, LPC | |
216 Hospital Ave, Marion, VA 24354-3157 | |
(276) 783-8185 | |
(276) 783-5030 |
Full Name | Cassandra Eden Untiedt |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 216 Hospital Ave, Marion, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093598286 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 0701012744 (Virginia) | Primary |
Entity Name | Mount Rogers Community Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255365599 PECOS PAC ID: 1254387475 Enrollment ID: O20050510001179 |
Mailing Address | Practice Location Address |
---|---|
Cassandra Eden Untiedt, LPC 770 W Ridge Rd, Wytheville, VA 24382-1187 Ph: (276) 223-3200 | Cassandra Eden Untiedt, LPC 216 Hospital Ave, Marion, VA 24354-3157 Ph: (276) 783-8185 |
Joshua Richardson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1590 N Main St, Marion, VA 24354 Phone: 276-783-8185 | |
James Rodney Roberts, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 416 E Main St, Marion, VA 24354 Phone: 276-783-8185 | |
Tracy Michelle Carter Robinson, LPC Counselor Medicare: Medicare Enrolled Practice Location: 121 Broad St, Marion, VA 24354 Phone: 276-781-5900 Fax: 276-782-9153 | |
Phillip Howard Moser Ii, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 216 Hospital Ave, Marion, VA 24354 Phone: 276-783-8185 Fax: 276-783-5030 | |
Leah Elizabeth Jackson, LPC Counselor Medicare: Medicare Enrolled Practice Location: 216 Hospital Ave, Marion, VA 24354 Phone: 276-783-8185 Fax: 276-783-5030 | |
Gay Alesia Holbrook, LPC Counselor Medicare: Medicare Enrolled Practice Location: 228 Trump Dr, Marion, VA 24354 Phone: 276-685-3108 |