| 4 Rivers Counseling Llc | |
|
300 Franklin St Ste 236 Martinsville VA 24112-2162 | |
| (276) 226-0307 | |
| Not Available |
| Full Name | 4 Rivers Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 300 Franklin St Ste 236, Martinsville, Virginia |
| Authorized Official Name and Position | Jennifer Yates (OWNER) |
| Authorized Official Contact | 2762260307 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 Rivers Counseling Llc 300 Franklin St Ste 236 Martinsville VA 24112-2162 Ph: () - | 4 Rivers Counseling Llc 300 Franklin St Ste 236 Martinsville VA 24112-2162 Ph: (276) 226-0307 |
| NPI Number | 1699404012 |
|---|---|
| Provider Enumeration Date | 06/09/2022 |
| Last Update Date | 08/09/2023 |
| Certification Date | 08/09/2023 |
| Medicare PECOS PAC ID | 0042692568 |
|---|---|
| Medicare Enrollment ID | O20220801000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699404012 | NPI | - | NPPES |
| N121 | Other | VA | MEDICARE |
| 30017460770001 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer Yates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194842112 PECOS PAC ID: 6204181803 Enrollment ID: I20180622001725 |
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