| Integrated Behavioral Healthcare Services, Pa | |
|
2577 Ravenhill Dr Fayetteville NC 28303-5451 | |
| (910) 438-0947 | |
| (910) 438-0906 |
| Full Name | Integrated Behavioral Healthcare Services, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 2577 Ravenhill Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Leigh Edwards (OFFICE MANAGER) |
| Authorized Official Contact | 9104380947 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Behavioral Healthcare Services, Pa 2577 Ravenhill Dr Fayetteville NC 28303-5451 Ph: (910) 438-0947 | Integrated Behavioral Healthcare Services, Pa 2577 Ravenhill Dr Fayetteville NC 28303-5451 Ph: (910) 438-0947 |
| NPI Number | 1689842551 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 07/21/2022 |
| Certification Date | 10/28/2021 |
| Medicare PECOS PAC ID | 8729040316 |
|---|---|
| Medicare Enrollment ID | O20041027000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689842551 | NPI | - | NPPES |
| 6107386 | Medicaid | NC | |
| 89014M6 | Medicaid | NC |
| Provider Name | Mark S Chandler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871659557 PECOS PAC ID: 8729121512 Enrollment ID: I20100224000031 |
| Provider Name | Muhammad W Haq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447357991 PECOS PAC ID: 4587791561 Enrollment ID: I20100422000953 |
| Provider Name | Douglas R Parrish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558365379 PECOS PAC ID: 9931101441 Enrollment ID: I20100819001174 |
| Provider Name | Kasandra C Anspach Sportsman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083703318 PECOS PAC ID: 3870743826 Enrollment ID: I20121029000109 |
| Provider Name | Kelly Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275819617 PECOS PAC ID: 1951626308 Enrollment ID: I20150206001204 |
| Provider Name | Jennifer Diane Coughenour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073984878 PECOS PAC ID: 0749585560 Enrollment ID: I20160216001622 |
| Provider Name | Juanita Massol |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659664324 PECOS PAC ID: 5698030203 Enrollment ID: I20180601001005 |
| Provider Name | Telisa Pharris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871944124 PECOS PAC ID: 4082964069 Enrollment ID: I20180912003457 |
| Provider Name | Celeste A Mcveigh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700390895 PECOS PAC ID: 4880921295 Enrollment ID: I20190808000232 |
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