Lynette M Mccorkle, LPC | |
3144 Vanzile Road, Crandon, WI 54520-8149 | |
(715) 478-5180 | |
(715) 478-5904 |
Full Name | Lynette M Mccorkle |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 3144 Vanzile Road, Crandon, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609115682 | NPI | - | NPPES |
100028082 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 5471-125 (Wisconsin) | Secondary |
101YM0800X | Counselor - Mental Health | 5471 (Wisconsin) | Primary |
Entity Name | Sokaogon Chippewa Community |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033115456 PECOS PAC ID: 1759370869 Enrollment ID: O20040512000238 |
Mailing Address | Practice Location Address |
---|---|
Lynette M Mccorkle, LPC 3144 Vanzile Road, Crandon, WI 54520-8149 Ph: (715) 478-5180 | Lynette M Mccorkle, LPC 3144 Vanzile Road, Crandon, WI 54520-8149 Ph: (715) 478-5180 |
James Seymour, CSW/CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4332 | |
Jennifer Krzmarcik, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4370 | |
David Rynearson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4300 | |
Karen A Minx, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3144 Vanzile Road, Crandon, WI 54520 Phone: 715-478-5180 Fax: 715-478-5904 | |
Nicholas Bolte, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4300 | |
Diane M Baird, LICENSED PROFESSIONA Counselor Medicare: Medicare Enrolled Practice Location: 3163 State Hwy 55, Crandon, WI 54520 Phone: 715-478-5180 Fax: 715-478-5904 | |
Jolene A Derfus, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3144 Vanzile Rd, Crandon, WI 54520 Phone: 715-478-5180 |