| Autism Services Center, Inc. | |
|
10 6th Ave W Huntington WV 25701-0028 | |
| (304) 525-8014 | |
| (304) 525-8026 |
| Full Name | Autism Services Center, Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10 6th Ave W, Huntington, West Virginia |
| Authorized Official Name and Position | Jimmie David Beirne (CEO) |
| Authorized Official Contact | 3045258014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Services Center, Inc. 10 6th Ave W Huntington WV 25701-0028 Ph: (304) 525-8014 | Autism Services Center, Inc. 10 6th Ave W Huntington WV 25701-0028 Ph: (304) 525-8014 |
| NPI Number | 1144889981 |
|---|---|
| Provider Enumeration Date | 06/06/2019 |
| Last Update Date | 01/29/2020 |
| Certification Date | 01/29/2020 |
| Medicare PECOS PAC ID | 1759716376 |
|---|---|
| Medicare Enrollment ID | O20200108002214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144889981 | NPI | - | NPPES |
| Provider Name | Jimmie Tyler Beirne |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508408881 PECOS PAC ID: 3678900420 Enrollment ID: I20200217004763 |
| Provider Name | Cameron Yoho Brown |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528600814 PECOS PAC ID: 0840627691 Enrollment ID: I20200217004819 |
| Provider Name | Heidi Ruth Dennison |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1174177760 PECOS PAC ID: 2567890650 Enrollment ID: I20200324002411 |
| Provider Name | Emily Lewis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700322047 PECOS PAC ID: 0840629119 Enrollment ID: I20200408000104 |
| Provider Name | Kimberly Jo Mckenzie |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1740816305 PECOS PAC ID: 8820428469 Enrollment ID: I20200422000303 |
| Provider Name | Hannah Elaine Lewis |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1992390918 PECOS PAC ID: 8426458985 Enrollment ID: I20210621002529 |
| Provider Name | Courtney Melvin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205252459 PECOS PAC ID: 1557773553 Enrollment ID: I20211025002000 |
| Provider Name | Kristina Dawn Stowers |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386603645 PECOS PAC ID: 8325437452 Enrollment ID: I20211215000183 |
| Provider Name | Kyra Caudill |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801394135 PECOS PAC ID: 5597091314 Enrollment ID: I20220830001429 |
| Provider Name | Rachel Alyson Nordmoe |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861192585 PECOS PAC ID: 4385019744 Enrollment ID: I20230518002773 |
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