| Bridgewater Counseling Services Pc | |
|
108 West College Street Bridgewater VA 22812-1124 | |
| (540) 828-3663 | |
| (540) 828-2322 |
| Full Name | Bridgewater Counseling Services Pc |
|---|---|
| Speciality | Social Worker |
| Location | 108 West College Street, Bridgewater, Virginia |
| Authorized Official Name and Position | Scott W Mandeville (OWNER) |
| Authorized Official Contact | 5408283663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgewater Counseling Services Pc 108 West College Street Bridgewater VA 22812-1124 Ph: (540) 828-3663 | Bridgewater Counseling Services Pc 108 West College Street Bridgewater VA 22812-1124 Ph: (540) 828-3663 |
| NPI Number | 1891959169 |
|---|---|
| Provider Enumeration Date | 07/15/2008 |
| Last Update Date | 12/13/2012 |
| Medicare PECOS PAC ID | 1052362324 |
|---|---|
| Medicare Enrollment ID | O20050203000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891959169 | NPI | - | NPPES |
| 1891959169 | Medicaid | VA | |
| 219164 | Other | VA | COM-PSYCH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0812000382 (Virginia) | Secondary |
| 1041C0700X | Social Worker - Clinical | 0904002990 (Virginia) | Primary |
| Provider Name | Scott W Mandeville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437110657 PECOS PAC ID: 2365493434 Enrollment ID: I20050208000117 |
Sapphire Valley Wellness Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 S Main St, Bridgewater, VA 22812 Phone: 540-908-8682 | |
Journey Counseling Ministries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 W College St, Bridgewater, VA 22812 Phone: 540-908-2792 | |
Bridgewater Counseling Services, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 S Main St, Bridgewater, VA 22812 Phone: 540-828-3663 Fax: 540-828-2322 |