Graceway Counseling Center | |
744 4th Ave Ste 2 Huntington WV 25701-1541 | |
(304) 691-0873 | |
(304) 955-9057 |
Full Name | Graceway Counseling Center |
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Speciality | Nurse Practitioner |
Location | 744 4th Ave Ste 2, Huntington, West Virginia |
Authorized Official Name and Position | Matthew Maynard (OWNER) |
Authorized Official Contact | 3046910873 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Graceway Counseling Center 744 4th Ave Ste 2 Huntington WV 25701-1541 Ph: (304) 691-0873 | Graceway Counseling Center 744 4th Ave Ste 2 Huntington WV 25701-1541 Ph: (304) 691-0873 |
NPI Number | 1003405978 |
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Provider Enumeration Date | 01/14/2021 |
Last Update Date | 09/05/2024 |
Certification Date | 09/05/2024 |
Medicare PECOS PAC ID | 2264894963 |
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Medicare Enrollment ID | O20230811002420 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003405978 | NPI | - | NPPES |
Provider Name | Rebeka A Copley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376090050 PECOS PAC ID: 4486922317 Enrollment ID: I20170619002048 |
Provider Name | Thomas Lester |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1962809293 PECOS PAC ID: 9537504584 Enrollment ID: I20240229000571 |
Provider Name | Jacqueline Rollyson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1275292054 PECOS PAC ID: 6800231861 Enrollment ID: I20240229000938 |
Provider Name | Matthew Maynard |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1750970711 PECOS PAC ID: 4486638244 Enrollment ID: I20240306001335 |
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