| Aegis Mental Health | |
|
2430 Monticello Rd Somerset KY 42501-3019 | |
| (606) 425-4567 | |
| Not Available |
| Full Name | Aegis Mental Health |
|---|---|
| Speciality | Counselor |
| Location | 2430 Monticello Rd, Somerset, Kentucky |
| Authorized Official Name and Position | Samantha Wilson (PARTNER) |
| Authorized Official Contact | 8593586568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aegis Mental Health 2430 Monticello Rd Somerset KY 42501-3019 Ph: () - | Aegis Mental Health 2430 Monticello Rd Somerset KY 42501-3019 Ph: (606) 425-4567 |
| NPI Number | 1295400083 |
|---|---|
| Provider Enumeration Date | 08/12/2021 |
| Last Update Date | 08/12/2021 |
| Certification Date | 08/12/2021 |
| Medicare PECOS PAC ID | 7618349366 |
|---|---|
| Medicare Enrollment ID | O20230207002097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295400083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Gabrielle Kiedren Louise Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811613995 PECOS PAC ID: 9537538525 Enrollment ID: I20221214001256 |
| Provider Name | Deanna Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215634902 PECOS PAC ID: 8224402656 Enrollment ID: I20230324002145 |
| Provider Name | Samantha Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588986178 PECOS PAC ID: 3779955430 Enrollment ID: I20240325002673 |
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