| Jewish Family Services Of Greater Charlotte, Inc | |
|
5007 Providence Rd #105 Charlotte NC 28226-5849 | |
| (704) 364-6594 | |
| (704) 364-6596 |
| Full Name | Jewish Family Services Of Greater Charlotte, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 5007 Providence Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Jean Morgan (OFFICE MANAGER) |
| Authorized Official Contact | 7043646594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jewish Family Services Of Greater Charlotte, Inc 5007 Providence Rd #105 Charlotte NC 28226-5849 Ph: (704) 364-6594 | Jewish Family Services Of Greater Charlotte, Inc 5007 Providence Rd #105 Charlotte NC 28226-5849 Ph: (704) 364-6594 |
| NPI Number | 1083691695 |
|---|---|
| Provider Enumeration Date | 12/23/2005 |
| Last Update Date | 02/03/2021 |
| Certification Date | 02/03/2021 |
| Medicare PECOS PAC ID | 4587616586 |
|---|---|
| Medicare Enrollment ID | O20050217000925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083691695 | NPI | - | NPPES |
| 60054 | Other | NC | AETNA |
| 6005372 | Medicaid | NC | |
| 0247W | Other | NC | BLUE CROSS/BLUE SHIELD |
| 221170000 | Other | NC | MAGELLAN BEHAVIORAL HEALT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amanda Sara Levine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063983302 PECOS PAC ID: 2466867817 Enrollment ID: I20210216002794 |
| Provider Name | Loriann Rose Devito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962993113 PECOS PAC ID: 5991110249 Enrollment ID: I20210218000592 |
| Provider Name | Alexis Shea Strouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477997864 PECOS PAC ID: 9830504125 Enrollment ID: I20210218002198 |
| Provider Name | Sara Marie Scheibner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659038222 PECOS PAC ID: 8224428909 Enrollment ID: I20211213000991 |
| Provider Name | Courtney Merchant Lawrence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336878776 PECOS PAC ID: 6709267792 Enrollment ID: I20220722000163 |
| Provider Name | Richard O'neale Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043929896 PECOS PAC ID: 4587024724 Enrollment ID: I20230719001475 |
| Provider Name | Emily Anna Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588250922 PECOS PAC ID: 3678915881 Enrollment ID: I20240520002341 |
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