Higher Ground Wellness | |
1616 W Church St Ste A Newark OH 43055-1540 | |
(740) 562-6500 | |
Not Available |
Full Name | Higher Ground Wellness |
---|---|
Speciality | Social Worker |
Location | 1616 W Church St Ste A, Newark, Ohio |
Authorized Official Name and Position | Mallory Moody (OWNER) |
Authorized Official Contact | 7405626500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Higher Ground Wellness 514 Arlington Ave Newark OH 43055-6886 Ph: (740) 562-6500 | Higher Ground Wellness 1616 W Church St Ste A Newark OH 43055-1540 Ph: (740) 562-6500 |
NPI Number | 1437891736 |
---|---|
Provider Enumeration Date | 04/08/2022 |
Last Update Date | 05/18/2022 |
Certification Date | 05/18/2022 |
Medicare PECOS PAC ID | 3274915905 |
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Medicare Enrollment ID | O20220727004176 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437891736 | NPI | - | NPPES |
1437667755 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Mallory Lynn Moody |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1437667755 PECOS PAC ID: 5092197723 Enrollment ID: I20220727004330 |
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