| Behavioral Healthcare Of Fredericksburg Pllc | |
|
407 Westwood Office Park Fredericksburg VA 22401-5109 | |
| (540) 310-0797 | |
| (540) 310-0791 |
| Full Name | Behavioral Healthcare Of Fredericksburg Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 407 Westwood Office Park, Fredericksburg, Virginia |
| Authorized Official Name and Position | Deborah A Jockin (OWNER) |
| Authorized Official Contact | 5403100797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Healthcare Of Fredericksburg Pllc 407 Westwood Office Park Fredericksburg VA 22401-5109 Ph: (540) 310-0797 | Behavioral Healthcare Of Fredericksburg Pllc 407 Westwood Office Park Fredericksburg VA 22401-5109 Ph: (540) 310-0797 |
| NPI Number | 1700956398 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Medicare PECOS PAC ID | 4385617539 |
|---|---|
| Medicare Enrollment ID | O20040816001072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700956398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904004481 (Virginia) | Primary |
| Provider Name | Deborah A Jockin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215014576 PECOS PAC ID: 0547233702 Enrollment ID: I20040816001096 |
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