Ivan T Jines, LPCC | |
507 Trojan Trl, Glasgow, KY 42141-2214 | |
(844) 435-0900 | |
(270) 858-4029 |
Full Name | Ivan T Jines |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 507 Trojan Trl, Glasgow, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558739474 | NPI | - | NPPES |
14407125 | Other | CAQH | |
7100587150 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 247523 (Kentucky) | Primary |
Entity Name | Cumberland Family Medical Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306873500 PECOS PAC ID: 6305947789 Enrollment ID: O20120221000433 |
Mailing Address | Practice Location Address |
---|---|
Ivan T Jines, LPCC Po Box 1080, Burkesville, KY 42717-1080 Ph: (270) 858-6655 | Ivan T Jines, LPCC 507 Trojan Trl, Glasgow, KY 42141-2214 Ph: (844) 435-0900 |
Natalie Ann Curry, TCADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 621 Happy Valley Rd, Glasgow, KY 42141 Phone: 833-510-4357 | |
Ms. Amber Denise Rahim, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 104 Reynolds Rd, Glasgow, KY 42141 Phone: 270-307-1935 | |
Derrick Wagoner, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 104 Reynolds Rd, Glasgow, KY 42141 Phone: 270-678-4801 Fax: 270-678-3866 | |
Amy Brickler, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 104 Reynolds Rd, Glasgow, KY 42141 Phone: 270-678-4801 Fax: 270-678-3866 | |
Liisa Lucas, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 608 Happy Valley Rd, Glasgow, KY 42141 Phone: 270-901-5000 | |
April Crenshaw, Counselor Medicare: Not Enrolled in Medicare Practice Location: 608 Happy Valley Rd, Glasgow, KY 42141 Phone: 270-901-5000 Fax: 270-842-5268 | |
Rachael Keeling, Counselor Medicare: Not Enrolled in Medicare Practice Location: 104 Reynolds Rd, Glasgow, KY 42141 Phone: 270-904-6567 |