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96 Campbell St Harrisonburg VA 22801-4010 | |
| (540) 433-1546 | |
| (540) 433-9631 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 96 Campbell St, Harrisonburg, Virginia |
| Authorized Official Name and Position | Sheila Early (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5404331546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
96 Campbell St Harrisonburg VA 22801-4010 Ph: (540) 433-1546 | 96 Campbell St Harrisonburg VA 22801-4010 Ph: (540) 433-1546 |
| NPI Number | 1639218373 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6800286337 |
|---|---|
| Medicare Enrollment ID | O20211124000395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639218373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Virginia) | Primary |
| Provider Name | Deborah J Brinkley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316565518 PECOS PAC ID: 2668754789 Enrollment ID: I20170126000259 |
| Provider Name | Liza Koonin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477072361 PECOS PAC ID: 0345582045 Enrollment ID: I20190430000001 |
| Provider Name | Sylvia W Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902470248 PECOS PAC ID: 6305237090 Enrollment ID: I20220107001135 |
| Provider Name | Brendaly Nieves Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396524815 PECOS PAC ID: 6800247107 Enrollment ID: I20240111001662 |
| Provider Name | Brian Jacob Martin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871042879 PECOS PAC ID: 5890185326 Enrollment ID: I20240805002102 |
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