Tatiana Mitchell, | |
196 E Emmitt Ave, Waverly, OH 45690-1334 | |
(740) 947-6727 | |
Not Available |
Full Name | Tatiana Mitchell |
---|---|
Gender | Female |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 196 E Emmitt Ave, Waverly, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306320981 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 1801212-TRNE (Ohio) | Primary |
Entity Name | Scioto Paint Valley Mental Health Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255308136 PECOS PAC ID: 7315832532 Enrollment ID: O20040217000830 |
Mailing Address | Practice Location Address |
---|---|
Tatiana Mitchell, 4029 Blendon Grove Way, Columbus, OH 43230-9857 Ph: () - | Tatiana Mitchell, 196 E Emmitt Ave, Waverly, OH 45690-1334 Ph: (740) 947-6727 |
David William Laverick Jr., CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 14574 Us Highway 23, Waverly, OH 45690 Phone: 740-912-9126 Fax: 740-912-9126 | |
Evan Ray Brown I, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14574 Us Highway 23, Waverly, OH 45690 Phone: 740-912-9126 | |
Paul Richard Coyle, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 14574 Us Highway 23, Waverly, OH 45690 Phone: 740-912-9126 | |
Jacob Wade Howard, CMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 14574 Us Highway 23, Waverly, OH 45690 Phone: 740-708-2967 | |
Rene Nicole Ponting, Counselor Medicare: Not Enrolled in Medicare Practice Location: 196 E Emmitt Ave, Waverly, OH 45690 Phone: 740-912-9499 | |
Brent J Wing, CT,CDA Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Dawn Ln, Waverly, OH 45690 Phone: 740-947-7783 | |
Stacey Nicole Stapleton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 194 E Emmitt Ave, Waverly, OH 45690 Phone: 740-835-8485 |