| Medella Counseling Services | |
|
7700 State Route 42 S Mansfield OH 44904-9401 | |
| (740) 398-7431 | |
| Not Available |
| Full Name | Medella Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 7700 State Route 42 S, Mansfield, Ohio |
| Authorized Official Name and Position | Jerry D Hartman (DIRECTOR) |
| Authorized Official Contact | 7403987431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medella Counseling Services 7700 State Route 42 S Mansfield OH 44904-9401 Ph: (740) 398-7431 | Medella Counseling Services 7700 State Route 42 S Mansfield OH 44904-9401 Ph: (740) 398-7431 |
| NPI Number | 1003534843 |
|---|---|
| Provider Enumeration Date | 08/18/2022 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/06/2023 |
| Medicare PECOS PAC ID | 4486028933 |
|---|---|
| Medicare Enrollment ID | O20230323001453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003534843 | NPI | - | NPPES |
| 0166847 | Medicaid | OH | |
| 0166326 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jerry Douglas Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184811127 PECOS PAC ID: 5799917456 Enrollment ID: I20230323001584 |
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