Debora Lea Humphrey, | |
74 Eclipse Ctr, Beloit, WI 53511-3550 | |
(608) 361-0311 | |
Not Available |
Full Name | Debora Lea Humphrey |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 74 Eclipse Ctr, Beloit, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699161166 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 7886-125 (Wisconsin) | Primary |
Entity Name | Community Health Systems Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750390670 PECOS PAC ID: 3678565116 Enrollment ID: O20040402000368 |
Entity Name | Community Health Systems Inc |
---|---|
Entity Type | Part A Provider - Federally Qualified Health Center (fqhc) |
Entity Identifiers | NPI Number: 1750390670 PECOS PAC ID: 3678565116 Enrollment ID: O20080514000417 |
Mailing Address | Practice Location Address |
---|---|
Debora Lea Humphrey, 74 Eclipse Ctr, Beloit, WI 53511-3550 Ph: (608) 361-0311 | Debora Lea Humphrey, 74 Eclipse Ctr, Beloit, WI 53511-3550 Ph: (608) 361-0311 |
Mr. Gregory Arthur Ammon, LPC MS NCC Counselor Medicare: Medicare Enrolled Practice Location: 1969 W Hart Road, Beloit, WI 53511 Phone: 608-364-5686 Fax: 608-363-5756 | |
Rhonda S Doherty, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 64 Eclipse Cetner, Beloit, WI 53511 Phone: 608-363-6200 | |
Mr. Haven Macgregor Mcclure, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1517 E Huebbe Pkwy Ste A, Beloit, WI 53511 Phone: 815-276-4432 Fax: 608-713-9040 | |
Mrs. Sally J Greer, MS LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1969 W Hart Rd, Beloit, WI 53511 Phone: 608-364-5686 Fax: 608-363-5756 | |
Mary T Pauli, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 136 W Grand Ave Ste 250, Beloit, WI 53511 Phone: 608-346-8315 | |
Sarah Jane Petersen, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 540 E Grand Ave, Beloit, WI 53511 Phone: 608-368-8087 | |
Mrs. Cristina Lynne Kroeze, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1969 W Hart Rd, Counseling Care Center, Beloit, WI 53511 Phone: 608-364-5686 |