Jamie Lynn Pelfrey, | |
600 W 3rd St, Mansfield, OH 44906-2633 | |
(419) 522-6191 | |
(419) 525-6723 |
Full Name | Jamie Lynn Pelfrey |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 600 W 3rd St, Mansfield, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730771593 | NPI | - | NPPES |
0433275 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | LCDCII.161488 (Ohio) | Secondary |
1041C0700X | Social Worker - Clinical | I.2304248 (Ohio) | Primary |
Entity Name | Third Street Community Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649599119 PECOS PAC ID: 2365423977 Enrollment ID: O20040528000770 |
Entity Name | Third Street Community Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Public Health/welfare Agency |
Entity Identifiers | NPI Number: 1336252519 PECOS PAC ID: 2365423977 Enrollment ID: O20071009000076 |
Entity Name | Third Street Community Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720407554 PECOS PAC ID: 2365423977 Enrollment ID: O20141020001750 |
Entity Name | Third Street Community Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972053452 PECOS PAC ID: 2365423977 Enrollment ID: O20161212001804 |
Entity Name | Third Street Community Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306499314 PECOS PAC ID: 2365423977 Enrollment ID: O20200420003356 |
Entity Name | Third Street Community Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629620109 PECOS PAC ID: 2365423977 Enrollment ID: O20200520001554 |
Mailing Address | Practice Location Address |
---|---|
Jamie Lynn Pelfrey, 600 W 3rd St, Mansfield, OH 44906-2633 Ph: (419) 522-6191 | Jamie Lynn Pelfrey, 600 W 3rd St, Mansfield, OH 44906-2633 Ph: (419) 522-6191 |