Lorenz Vassa Falls, | |
1260 College Ave Ste 1, Wilkesboro, NC 28697-2700 | |
(336) 818-0734 | |
Not Available |
Full Name | Lorenz Vassa Falls |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 1260 College Ave Ste 1, Wilkesboro, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1205409935 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | A12546 (North Carolina) | Primary |
Entity Name | Jodi Province Counseling Services Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194050435 PECOS PAC ID: 3678726569 Enrollment ID: O20121228000228 |
Mailing Address | Practice Location Address |
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Lorenz Vassa Falls, 1260 College Ave Ste 1, Wilkesboro, NC 28697-2700 Ph: () - | Lorenz Vassa Falls, 1260 College Ave Ste 1, Wilkesboro, NC 28697-2700 Ph: (336) 818-0734 |
Ms. Lynn Durchman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 507 Courthouse Dr, Wilkesboro, NC 28697 Phone: 336-667-3333 Fax: 336-667-8749 | |
Kendra G. Perkins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1232 School St, Wilkesboro, NC 28697 Phone: 336-838-4883 Fax: 336-838-4891 | |
Jami Lynn Cantrell, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1260 College Ave, Wilkesboro, NC 28697 Phone: 336-818-0733 Fax: 336-818-0734 | |
Mr. Gene F. Stone, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 403 E Main St, Wilkesboro, NC 28697 Phone: 336-984-1697 Fax: 336-984-1697 | |
Morganne Rayo, LCSW, LCAS Counselor Medicare: Medicare Enrolled Practice Location: 1260 College Ave Ste 1, Wilkesboro, NC 28697 Phone: 336-818-0733 | |
Ashley Dyer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1260 College Ave Ste 1, Wilkesboro, NC 28697 Phone: 336-818-0733 |