| Meherrin River Counseling Services | |
|
9201 State Highway 17 Ste A Elgin OK 73538-4517 | |
| (434) 848-5178 | |
| (580) 492-4609 |
| Full Name | Meherrin River Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 9201 State Highway 17 Ste A, Elgin, Oklahoma |
| Authorized Official Name and Position | Emma L Short (OWNER) |
| Authorized Official Contact | 5804924604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meherrin River Counseling Services 45042 County Street 2680 Cyril OK 73029-2111 Ph: (434) 848-5178 | Meherrin River Counseling Services 9201 State Highway 17 Ste A Elgin OK 73538-4517 Ph: (434) 848-5178 |
| NPI Number | 1942614631 |
|---|---|
| Provider Enumeration Date | 06/20/2014 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Medicare PECOS PAC ID | 3870811565 |
|---|---|
| Medicare Enrollment ID | O20150408002619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942614631 | NPI | - | NPPES |
| 1124216577 | Medicaid | VA | |
| 1124216577 | Medicaid | OK | |
| 1942614631 | Other | COMPANY NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Tessie S Sadler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184792384 PECOS PAC ID: 2466488788 Enrollment ID: I20050708000619 |
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