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508 Dickson St Ste 2 Wellington OH 44090-1300 | |
| (330) 636-0428 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 508 Dickson St Ste 2, Wellington, Ohio |
| Authorized Official Name and Position | Sarah Papesh (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3306360428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 359 Wellington OH 44090-0359 Ph: () - | 508 Dickson St Ste 2 Wellington OH 44090-1300 Ph: (330) 636-0428 |
| NPI Number | 1023779303 |
|---|---|
| Provider Enumeration Date | 01/07/2022 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 9436597200 |
|---|---|
| Medicare Enrollment ID | O20240329002605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023779303 | NPI | - | NPPES |
| Provider Name | Theresa L Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255848404 PECOS PAC ID: 5991118523 Enrollment ID: I20201228002394 |
| Provider Name | Sarah Papesh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790148096 PECOS PAC ID: 1254779028 Enrollment ID: I20240529003990 |
| Provider Name | Mackenzie Stoll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689145815 PECOS PAC ID: 5193266989 Enrollment ID: I20240919003485 |
| Provider Name | Matthew L Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861800898 PECOS PAC ID: 8325572852 Enrollment ID: I20241106003544 |