Ms Melissa Jane Hansford, LPCC | |
109 S 4th St Ste 2, Williamsburg, KY 40769-1221 | |
(606) 304-7994 | |
Not Available |
Full Name | Ms Melissa Jane Hansford |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 109 S 4th St Ste 2, Williamsburg, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356700710 | NPI | - | NPPES |
242650 | Other | KY | STATE LICENSE |
7100566260 | Medicaid | KY | |
LPC4786 | Other | TN | STATE LICENSE |
Q047626 | Medicaid | TN |
Entity Name | Southern Roots Therapeutic Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851155014 PECOS PAC ID: 5395184717 Enrollment ID: O20240418001943 |
Mailing Address | Practice Location Address |
---|---|
Ms Melissa Jane Hansford, LPCC 74 Falin Ln, Williamsburg, KY 40769-1791 Ph: (606) 304-7994 | Ms Melissa Jane Hansford, LPCC 109 S 4th St Ste 2, Williamsburg, KY 40769-1221 Ph: (606) 304-7994 |
Lyndsay Erin Baker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 386 Brush Arbor Rd, Williamsburg, KY 40769 Phone: 606-215-6173 | |
Hannah Ruth Stephens, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1047 S Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-2656 | |
Ms. Tarah Jean Kidd, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-0123 | |
Sarah Patricia Cloud, Counselor Medicare: Not Enrolled in Medicare Practice Location: 76 Wilson Rd, Williamsburg, KY 40769 Phone: 606-304-2499 | |
Brittany Manus, Counselor Medicare: Not Enrolled in Medicare Practice Location: 285 Cemetery Rd, Williamsburg, KY 40769 Phone: 606-549-1440 | |
Kristi Dawn Gray, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 896 S Highway 25 W, Williamsburg, KY 40769 Phone: 606-515-6124 Fax: 606-515-6163 |