Jennifer Marcella Wirt, LMHC | |
300 Ocean Ave, Raymond, WA 98577-3016 | |
(360) 942-3040 | |
(360) 942-3955 |
Full Name | Jennifer Marcella Wirt |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 300 Ocean Ave, Raymond, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902409709 | NPI | - | NPPES |
2212708 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | LH61306829 (Washington) | Primary |
Entity Name | Lewis County Community Health Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134164692 PECOS PAC ID: 6002803749 Enrollment ID: O20040426001899 |
Mailing Address | Practice Location Address |
---|---|
Jennifer Marcella Wirt, LMHC 2690 Ne Kresky Ave, Chehalis, WA 98532-2412 Ph: (360) 330-9595 | Jennifer Marcella Wirt, LMHC 300 Ocean Ave, Raymond, WA 98577-3016 Ph: (360) 942-3040 |
Katie Wymore, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 Ocean Ave, Raymond, WA 98577 Phone: 360-942-2303 | |
Cassandra Diane Hansen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 Ocean Ave, Raymond, WA 98577 Phone: 360-942-2303 Fax: 360-942-5312 | |
Mr. William Albert Grimberg, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 Ocean Ave, Raymond, WA 98577 Phone: 360-942-2303 Fax: 360-942-5312 | |
Trevor William Limbocker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 335 3rd St, Raymond, WA 98577 Phone: 360-890-5211 | |
Michaela Irene Eastham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1016 Commercial St, Raymond, WA 98577 Phone: 509-202-3901 | |
Katie May Ashe, CO61354716 Counselor Medicare: Not Enrolled in Medicare Practice Location: 1016 Commercial St, Raymond, WA 98577 Phone: 360-942-2474 | |
Macy Marie Karlsvik, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1016 Commercial St, Raymond, WA 98577 Phone: 360-942-2474 |