Grayson Leigh West, LPC | |
122 Gordon Commercial Dr Ste D, Lagrange, GA 30240-5754 | |
(706) 845-4054 | |
Not Available |
Full Name | Grayson Leigh West |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 122 Gordon Commercial Dr Ste D, Lagrange, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861034332 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC013923 (Georgia) | Primary |
101YM0800X | Counselor - Mental Health | (Georgia) | Secondary |
Entity Name | Personal Recovery Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096 |
Mailing Address | Practice Location Address |
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Grayson Leigh West, LPC 122 Gordon Commercial Dr Ste D, Lagrange, GA 30240-5754 Ph: () - | Grayson Leigh West, LPC 122 Gordon Commercial Dr Ste D, Lagrange, GA 30240-5754 Ph: (706) 845-4054 |
Martha Lynne Earley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240 Phone: 706-845-4054 Fax: 706-845-4367 | |
Mr. Walter Hue Scott Ii, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2233 West Point Rd., Lagrange, GA 30240 Phone: 706-837-0045 Fax: 706-837-0035 | |
Renonda Michelle Forney, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2233 W Point Rd, Lagrange, GA 30240 Phone: 706-837-0045 Fax: 706-837-0035 | |
Holly T Roberts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1111 Mooty Bridge Rd, Lagrange, GA 30240 Phone: 706-443-5433 | |
Christopher Blake Glaze, Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240 Phone: 706-845-4045 | |
Elizabeth Billiter, M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 C Gordon Commercial Dr, Lagrange, GA 30240 Phone: 706-845-4045 Fax: 706-845-4367 | |
Ms. Baxlee Bynum, M.ED, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 Gordon Commercial Dr, Lagrange, GA 30240 Phone: 706-845-4045 Fax: 706-845-4367 |