John Widener, LPC, LMFT | |
125 E Monroe St, Thomasville, GA 31792-5142 | |
(678) 577-8795 | |
(404) 860-2111 |
Full Name | John Widener |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 125 E Monroe St, Thomasville, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467906537 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | MFT001705 (Georgia) | Secondary |
101YM0800X | Counselor - Mental Health | LPC011205 (Georgia) | Primary |
Entity Name | Black Sheep Trauma And Recovery Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497407506 PECOS PAC ID: 4789020157 Enrollment ID: O20240307001587 |
Mailing Address | Practice Location Address |
---|---|
John Widener, LPC, LMFT 125 E Monroe St, Thomasville, GA 31792-5142 Ph: (678) 577-8795 | John Widener, LPC, LMFT 125 E Monroe St, Thomasville, GA 31792-5142 Ph: (678) 577-8795 |
Moses D Everett Jr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 228 Augusta Ave, Thomasville, GA 31792 Phone: 229-225-6682 | |
Caroline S Chandler, Counselor Medicare: Medicare Enrolled Practice Location: 1102 Smith Ave, Thomasville, GA 31792 Phone: 229-225-4335 Fax: 229-225-4374 | |
Nsikan D Essien, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1102 Smith Ave, Thomasville, GA 31792 Phone: 229-225-4335 Fax: 229-225-4374 | |
Mrs. Nicole Washington Gatlin, LPC, CRC, NCACII Counselor Medicare: Not Enrolled in Medicare Practice Location: 14382 Us Highway 19 S, Thomasville, GA 31757 Phone: 229-228-5545 Fax: 229-226-4755 | |
Mrs. Candace Crosby Humphries, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1102 Smith Ave, Suite M, Thomasville, GA 31792 Phone: 229-225-5208 Fax: 229-227-5458 | |
Stephanie Hardy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 575 Carrington Cir, Thomasville, GA 31757 Phone: 229-224-3019 | |
Heather Renee Hatchett, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1102 Smith Ave, Suite K, Thomasville, GA 31792 Phone: 229-225-5208 |