Corey Larue, | |
119 Walnut St, Johnstown, PA 15901-1625 | |
(814) 534-0745 | |
Not Available |
Full Name | Corey Larue |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 119 Walnut St, Johnstown, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013426253 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Lifeline Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265160451 PECOS PAC ID: 3678948577 Enrollment ID: O20230721002527 |
Mailing Address | Practice Location Address |
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Corey Larue, 119 Walnut St, Johnstown, PA 15901-1625 Ph: (814) 534-0745 | Corey Larue, 119 Walnut St, Johnstown, PA 15901-1625 Ph: (814) 534-0745 |
William Martin O'herrick, BSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 131 Market St, Johnstown, PA 15901 Phone: 814-535-2277 | |
Christine Mary Charney, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 131 Market St, Johnstown, PA 15901 Phone: 814-534-0745 Fax: 814-536-5431 | |
Tammy Zeek, Counselor Medicare: Medicare Enrolled Practice Location: 119 Walnut St, Johnstown, PA 15901 Phone: 814-534-0745 | |
Zita Burnheimer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 188 Gilbert St, Johnstown, PA 15906 Phone: 814-539-7339 Fax: 814-535-2219 | |
Jennifer Theresa Stevens, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 131 Market St, Johnstown, PA 15901 Phone: 814-535-2277 Fax: 814-539-0475 | |
Neha Rajan, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 865 Eisenhower Blvd, Johnstown, PA 15904 Phone: 814-266-8840 |