| Mesa Waa Gii, Llc | |
|
115 N Green St Ste 102 Crawfordsville IN 47933-1708 | |
| (765) 366-2644 | |
| Not Available |
| Full Name | Mesa Waa Gii, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 115 N Green St Ste 102, Crawfordsville, Indiana |
| Authorized Official Name and Position | Jamie Selby (OWNER/OPERATOR) |
| Authorized Official Contact | 7652315672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesa Waa Gii, Llc 115 N Green St Ste 102 Crawfordsville IN 47933-1708 Ph: (765) 366-2644 | Mesa Waa Gii, Llc 115 N Green St Ste 102 Crawfordsville IN 47933-1708 Ph: (765) 366-2644 |
| NPI Number | 1699546440 |
|---|---|
| Provider Enumeration Date | 01/10/2024 |
| Last Update Date | 03/04/2024 |
| Certification Date | 03/04/2024 |
| Medicare PECOS PAC ID | 1153761184 |
|---|---|
| Medicare Enrollment ID | O20240424002880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699546440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jamie M Selby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538727698 PECOS PAC ID: 4880034818 Enrollment ID: I20240429000367 |
H.o.p.e. Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1984 Indianapolis Rd, Crawfordsville, IN 47933 Phone: 765-364-0380 Fax: 765-364-6816 | |
Full Spectrum Aba Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 Meadow Ave, Crawfordsville, IN 47933 Phone: 317-318-4352 | |
Ryse Autism And Education Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1730 E 800 N, Crawfordsville, IN 47933 Phone: 765-432-2003 | |
Indiana Autism Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5597 N Lye Creek Pkwy, Crawfordsville, IN 47933 Phone: 765-366-1895 | |
Psychiatric Unit Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1710 Lafayette Rd, Crawfordsville, IN 47933 Phone: 765-362-2800 |