| Middle Peninsula Northern Neck Counseling Center | |
|
9228 George Washington Memorial Hwy Gloucester VA 23061-4162 | |
| (804) 693-5068 | |
| (804) 693-7407 |
| Full Name | Middle Peninsula Northern Neck Counseling Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 9228 George Washington Memorial Hwy, Gloucester, Virginia |
| Authorized Official Name and Position | Yvonne M Wingrove (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8046935640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Peninsula Northern Neck Counseling Center Po Box 269 Ark VA 23003-0269 Ph: (804) 693-5640 | Middle Peninsula Northern Neck Counseling Center 9228 George Washington Memorial Hwy Gloucester VA 23061-4162 Ph: (804) 693-5068 |
| NPI Number | 1497717615 |
|---|---|
| Provider Enumeration Date | 04/04/2006 |
| Last Update Date | 06/21/2018 |
| Medicare PECOS PAC ID | 1254235989 |
|---|---|
| Medicare Enrollment ID | O20031124000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497717615 | NPI | - | NPPES |
| 1497717615 | Medicaid | VA | |
| 294721 | Other | VA | VALUE OPTIONS |
| 250204 | Other | VA | ANTHEM |
| 250208 | Other | VA | ANTHEM |
| 004945115 | Medicaid | VA | |
| 250202 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Salman Siddiqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437110053 PECOS PAC ID: 4587568217 Enrollment ID: I20040209001180 |
| Provider Name | Lynn J Mccrobie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073747499 PECOS PAC ID: 1658317664 Enrollment ID: I20050629001222 |
| Provider Name | Parthiv J Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184685877 PECOS PAC ID: 9638107048 Enrollment ID: I20050727000910 |
| Provider Name | Victoria M Mckay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376795898 PECOS PAC ID: 6507906187 Enrollment ID: I20091211000268 |
| Provider Name | Shahana N Keisler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205890860 PECOS PAC ID: 8224162664 Enrollment ID: I20100820000033 |
| Provider Name | Lynne M Cerar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548549926 PECOS PAC ID: 5890934913 Enrollment ID: I20130621000446 |
| Provider Name | Albert Archard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447494661 PECOS PAC ID: 3173766052 Enrollment ID: I20130823001227 |
| Provider Name | Rajeev Srivastava |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437489770 PECOS PAC ID: 6608010145 Enrollment ID: I20150123000683 |
| Provider Name | Melissa B South |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821499609 PECOS PAC ID: 2163749839 Enrollment ID: I20150318001507 |
| Provider Name | Charles R Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205891546 PECOS PAC ID: 6507760238 Enrollment ID: I20150617002997 |
| Provider Name | Michele Burtner Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710354451 PECOS PAC ID: 6709186794 Enrollment ID: I20151123002772 |
| Provider Name | Brenda Lynne Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225013139 PECOS PAC ID: 9032191671 Enrollment ID: I20171128003344 |
| Provider Name | Elizabeth Swann Hirner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790255354 PECOS PAC ID: 0345588554 Enrollment ID: I20190214000091 |
| Provider Name | Quinatona Winston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366065625 PECOS PAC ID: 6002239886 Enrollment ID: I20200713001683 |
| Provider Name | Kimberly Waine Gore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700485927 PECOS PAC ID: 1153734728 Enrollment ID: I20201229001391 |
| Provider Name | Celeste Lcsw Carmody |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003419615 PECOS PAC ID: 9931513108 Enrollment ID: I20210129000320 |
| Provider Name | Philisha Woodard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023601812 PECOS PAC ID: 9133536840 Enrollment ID: I20210325000422 |
| Provider Name | Kelsey Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144898040 PECOS PAC ID: 0547663973 Enrollment ID: I20210722003629 |
| Provider Name | Daisy Overton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417615584 PECOS PAC ID: 2365835220 Enrollment ID: I20220217000959 |
| Provider Name | Michael A Barlow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265175053 PECOS PAC ID: 3274911490 Enrollment ID: I20220531002174 |
| Provider Name | Daeryl Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295397123 PECOS PAC ID: 9739513359 Enrollment ID: I20220819000338 |
| Provider Name | Susan A Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376064154 PECOS PAC ID: 4082984885 Enrollment ID: I20220929000861 |
| Provider Name | Sabrina Curry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306394986 PECOS PAC ID: 8729464599 Enrollment ID: I20220930002098 |
| Provider Name | Winona Pearson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396462289 PECOS PAC ID: 4284002056 Enrollment ID: I20221129001255 |
| Provider Name | Jessica Horton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235849324 PECOS PAC ID: 7517331416 Enrollment ID: I20230315003066 |
| Provider Name | Laura Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841927217 PECOS PAC ID: 7618332636 Enrollment ID: I20230426003131 |
| Provider Name | Amanda Campagnola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982326997 PECOS PAC ID: 3870954175 Enrollment ID: I20230802004454 |
| Provider Name | Anna M Cameron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912270596 PECOS PAC ID: 6507145612 Enrollment ID: I20231222001735 |
| Provider Name | Keshawna Tiggle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992421770 PECOS PAC ID: 8921458985 Enrollment ID: I20240103002009 |
| Provider Name | Christina Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801510763 PECOS PAC ID: 5698126639 Enrollment ID: I20240104000339 |
| Provider Name | Joanne P Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730213380 PECOS PAC ID: 8325268972 Enrollment ID: I20240104001653 |
| Provider Name | Pamela Minor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336690304 PECOS PAC ID: 0345691424 Enrollment ID: I20240112003646 |
| Provider Name | Patricia Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275019010 PECOS PAC ID: 6608227798 Enrollment ID: I20240112003733 |
| Provider Name | Shannon L. Hodges |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437321114 PECOS PAC ID: 2769834019 Enrollment ID: I20240123000721 |
| Provider Name | Caitlin L. Gallagher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881281053 PECOS PAC ID: 8022460302 Enrollment ID: I20240123001493 |
| Provider Name | Joshua Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770294456 PECOS PAC ID: 1850744889 Enrollment ID: I20240125004761 |
| Provider Name | Lecia Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740834936 PECOS PAC ID: 7214373760 Enrollment ID: I20240307000644 |
| Provider Name | Emily Eanes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104881309 PECOS PAC ID: 5991141160 Enrollment ID: I20240311000458 |
| Provider Name | Susan Horne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144680117 PECOS PAC ID: 4981040169 Enrollment ID: I20240311000861 |
| Provider Name | Butler Knight |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437113024 PECOS PAC ID: 0840636965 Enrollment ID: I20240312002108 |
| Provider Name | Brianna Low |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477159820 PECOS PAC ID: 8426494451 Enrollment ID: I20240312002849 |
| Provider Name | Brooke Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194580563 PECOS PAC ID: 8628416450 Enrollment ID: I20240329000809 |
| Provider Name | Wanda J Dungan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558323402 PECOS PAC ID: 0446699490 Enrollment ID: I20240423003892 |
| Provider Name | Stephanie L Doswell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134820335 PECOS PAC ID: 8224477286 Enrollment ID: I20240423004164 |
| Provider Name | Denise Ferguson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962264358 PECOS PAC ID: 8527500263 Enrollment ID: I20240610000397 |
Blue Water Aba Therapy, Co Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5472 Kings Dr, Gloucester, VA 23061 Phone: 804-824-2396 Fax: 804-824-2397 | |
Foundational Intervention And Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7082 Wellford Ln, Gloucester, VA 23061 Phone: 804-815-1259 Fax: 804-694-0694 | |
Our Life's Journey Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2723 Hickory Fork Rd, Gloucester, VA 23061 Phone: 757-630-2910 | |
Riverside Neurology And Sleep Specialists Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7547 Medial Drive, Suite 1300, Gloucester, VA 23061 Phone: 804-695-8550 Fax: 804-695-8551 | |
Willow Tree Healing Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1516 Newmoore Dr, Gloucester, VA 23061 Phone: 252-619-0887 | |
Thorpe Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6486 Main Street, Suite 10, Gloucester, VA 23061 Phone: 757-755-0263 | |
Drs. Phillips, Rose & Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7580 Hospital Dr, Sutie 201, Gloucester, VA 23061 Phone: 804-693-0810 Fax: 804-693-0211 |