James Gonnella, LICDC, GAMB, LSW | |
6539 Moses Rd, West Alexandria, OH 45381-8582 | |
(937) 461-5223 | |
(937) 461-7010 |
Full Name | James Gonnella |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 6539 Moses Rd, West Alexandria, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437512761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | S.1201491 (Ohio) | Primary |
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210316002509 |
Mailing Address | Practice Location Address |
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James Gonnella, LICDC, GAMB, LSW 6539 Moses Rd, West Alexandria, OH 45381-8582 Ph: (937) 461-5223 | James Gonnella, LICDC, GAMB, LSW 6539 Moses Rd, West Alexandria, OH 45381-8582 Ph: (937) 461-5223 |
Erica Marie Ostrander, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 43 W Dayton St, West Alexandria, OH 45381 Phone: 254-314-1388 | |
Mrs. Mary E. Moore, M.S., L.P.C.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 N Main St, West Alexandria, OH 45381 Phone: 937-839-5800 Fax: 937-839-5800 | |
Mrs. Hannah B. Castillo, M.S., L.P.C.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 N Main St, West Alexandria, OH 45381 Phone: 937-839-5800 Fax: 937-839-5800 |