| Divine Interventions Counseling Center, Llc | |
|
1810 Westwood Ave W Wilson NC 27893-2143 | |
| (252) 234-2048 | |
| (252) 234-2047 |
| Full Name | Divine Interventions Counseling Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1810 Westwood Ave W, Wilson, North Carolina |
| Authorized Official Name and Position | Janet Eleanore Yankosky (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2522342048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Interventions Counseling Center, Llc P.o. Box 3001 Wilson NC 27895-3001 Ph: (252) 234-2048 | Divine Interventions Counseling Center, Llc 1810 Westwood Ave W Wilson NC 27893-2143 Ph: (252) 234-2048 |
| NPI Number | 1245399203 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 10/27/2009 |
| Medicare PECOS PAC ID | 9638358732 |
|---|---|
| Medicare Enrollment ID | O20110121000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245399203 | NPI | - | NPPES |
| 6002897 | Medicaid | NC | |
| 2113388 | Other | NC | CIGNA PROVIDER NUMBER |
| 1379H | Other | NC | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C004270 (North Carolina) | Primary |
| Provider Name | Janet E Yankosky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164759619 PECOS PAC ID: 9931389343 Enrollment ID: I20110202000114 |
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