| Clarvida | |
|
5369 Peters Creek Rd Nw Roanoke VA 24019-3849 | |
| (540) 344-9501 | |
| (540) 344-7162 |
| Full Name | Clarvida |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5369 Peters Creek Rd Nw, Roanoke, Virginia |
| Authorized Official Name and Position | Melanie Johnson (AVP OF RCM) |
| Authorized Official Contact | 5407106085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarvida 10304 Spotsylvania Ave Suite 300 Fredericksburg VA 22408-8602 Ph: (540) 710-6085 | Clarvida 5369 Peters Creek Rd Nw Roanoke VA 24019-3849 Ph: (540) 344-9501 |
| NPI Number | 1093891335 |
|---|---|
| Provider Enumeration Date | 10/30/2006 |
| Last Update Date | 07/10/2024 |
| Certification Date | 07/10/2024 |
| Medicare PECOS PAC ID | 9537380746 |
|---|---|
| Medicare Enrollment ID | O20141030002599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093891335 | NPI | - | NPPES |
| 004945832 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 15805001 (Virginia) | Primary |
| Provider Name | Jason J Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275941536 PECOS PAC ID: 3476875295 Enrollment ID: I20141205002129 |
| Provider Name | Rebekah C Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417469958 PECOS PAC ID: 9032478425 Enrollment ID: I20220503000841 |
| Provider Name | Emily K Jennings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528569225 PECOS PAC ID: 7810348356 Enrollment ID: I20240109001578 |
Clarvida Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5369 Peters Creek Rd Nw, Roanoke, VA 24019 Phone: 540-344-9501 Fax: 540-344-7162 | |
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