| Amy H. Wells, Lcsw Pc | |
|
5050 Coppage Rd Hahira GA 31632-2506 | |
| (229) 630-1941 | |
| Not Available |
| Full Name | Amy H. Wells, Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 5050 Coppage Rd, Hahira, Georgia |
| Authorized Official Name and Position | Amy H. Wells (CEO) |
| Authorized Official Contact | 2296301941 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy H. Wells, Lcsw Pc 5050 Coppage Rd Hahira GA 31632-2506 Ph: (229) 630-1941 | Amy H. Wells, Lcsw Pc 5050 Coppage Rd Hahira GA 31632-2506 Ph: (229) 630-1941 |
| NPI Number | 1457616260 |
|---|---|
| Provider Enumeration Date | 07/08/2012 |
| Last Update Date | 07/08/2012 |
| Medicare PECOS PAC ID | 6709037757 |
|---|---|
| Medicare Enrollment ID | O20121121000445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457616260 | NPI | - | NPPES |
| 11830268 | Other | GA | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3036 (Georgia) | Primary |
| Provider Name | Amy H Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831127745 PECOS PAC ID: 4385651793 Enrollment ID: I20060309000423 |
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