Jenny Shealy, Lcsw Pa | |
67 Charlotte St Asheville NC 28801-2435 | |
(828) 279-5369 | |
Not Available |
Full Name | Jenny Shealy, Lcsw Pa |
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Speciality | Community/Behavioral Health |
Location | 67 Charlotte St, Asheville, North Carolina |
Authorized Official Name and Position | Jennifer Shealy (PRESIDENT) |
Authorized Official Contact | 8282795369 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jenny Shealy, Lcsw Pa 67 Charlotte St Asheville NC 28801-2435 Ph: () - | Jenny Shealy, Lcsw Pa 67 Charlotte St Asheville NC 28801-2435 Ph: (828) 279-5369 |
NPI Number | 1578958104 |
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Provider Enumeration Date | 03/31/2015 |
Last Update Date | 03/31/2015 |
Medicare PECOS PAC ID | 6204140262 |
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Medicare Enrollment ID | O20150804005129 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578958104 | NPI | - | NPPES |
6106848 | Medicaid | NC | |
2853495 | Other | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | C005923 (North Carolina) | Primary |
Provider Name | Jennifer L Shealy |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538347497 PECOS PAC ID: 8921143975 Enrollment ID: I20100302000971 |
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