| Mountain Comprehensive Care Center, Inc. | |
|
104 S Front Ave Prestonsburg KY 41653-1614 | |
| (606) 886-8572 | |
| (606) 886-4433 |
| Full Name | Mountain Comprehensive Care Center, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 104 S Front Ave, Prestonsburg, Kentucky |
| Authorized Official Name and Position | Promod Bishnoi (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6068868572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Comprehensive Care Center, Inc. 104 S Front Ave Prestonsburg KY 41653-1614 Ph: (606) 886-8572 | Mountain Comprehensive Care Center, Inc. 104 S Front Ave Prestonsburg KY 41653-1614 Ph: (606) 886-8572 |
| NPI Number | 1760491674 |
|---|---|
| Provider Enumeration Date | 08/07/2006 |
| Last Update Date | 01/29/2014 |
| Medicare PECOS PAC ID | 5294720553 |
|---|---|
| Medicare Enrollment ID | O20040416000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760491674 | NPI | - | NPPES |
| 28011013 | Medicaid | KY | |
| 30611016 | Medicaid | KY | |
| 27011014 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Corazon N Chua |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780686824 PECOS PAC ID: 0345232195 Enrollment ID: I20040401000053 |
| Provider Name | Roger D Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609880822 PECOS PAC ID: 1254327836 Enrollment ID: I20040421000066 |
| Provider Name | Joanna L Santiesteban |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700870078 PECOS PAC ID: 9638110315 Enrollment ID: I20050513000029 |
| Provider Name | Misty L Walter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922028737 PECOS PAC ID: 8729029327 Enrollment ID: I20050513000151 |
| Provider Name | Sabrina Jo Grubbs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417033002 PECOS PAC ID: 7012958531 Enrollment ID: I20050516000269 |
| Provider Name | Jason N Stamper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780635250 PECOS PAC ID: 1759312366 Enrollment ID: I20050823001137 |
| Provider Name | Sandra Faye Pratt |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1699769919 PECOS PAC ID: 4486669322 Enrollment ID: I20060214000019 |
| Provider Name | Mary June Kubach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619059623 PECOS PAC ID: 3678571718 Enrollment ID: I20061128000046 |
| Provider Name | Lorne B Cansler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699782326 PECOS PAC ID: 2567561913 Enrollment ID: I20070626000204 |
| Provider Name | Mary Ann Mosbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508064338 PECOS PAC ID: 0244325496 Enrollment ID: I20071002000837 |
| Provider Name | Krissy L Marcum |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922282078 PECOS PAC ID: 7214011915 Enrollment ID: I20080219000637 |
| Provider Name | Rakesh Sachdeva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881657054 PECOS PAC ID: 5799850210 Enrollment ID: I20080819000286 |
| Provider Name | James G Dumas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891705877 PECOS PAC ID: 6204994304 Enrollment ID: I20081017000655 |
| Provider Name | Martha E Copley Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487768990 PECOS PAC ID: 1658439765 Enrollment ID: I20081017000687 |
| Provider Name | Linda Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346323250 PECOS PAC ID: 0345309720 Enrollment ID: I20081030000674 |
| Provider Name | Kristal D Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396917639 PECOS PAC ID: 5890850820 Enrollment ID: I20090209000006 |
| Provider Name | Karen S Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518150812 PECOS PAC ID: 8325187933 Enrollment ID: I20091120000008 |
| Provider Name | Robin R Goble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154438984 PECOS PAC ID: 7911040779 Enrollment ID: I20100203000043 |
| Provider Name | Manmohan Pratap Pothuloori |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225020332 PECOS PAC ID: 9436143245 Enrollment ID: I20100526000395 |
| Provider Name | Brandie L Dotson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528083813 PECOS PAC ID: 9638168396 Enrollment ID: I20101206000692 |
| Provider Name | Laura M Napora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831249655 PECOS PAC ID: 9537356746 Enrollment ID: I20101213001155 |
| Provider Name | Rose Mccray Douglass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902955206 PECOS PAC ID: 4385832401 Enrollment ID: I20101216000007 |
| Provider Name | Benjamin J Darby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376536961 PECOS PAC ID: 3870782162 Enrollment ID: I20110119000031 |
| Provider Name | Umar Murad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952391724 PECOS PAC ID: 1759344179 Enrollment ID: I20110120000314 |
| Provider Name | Bonifacio Aranas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1033298641 PECOS PAC ID: 4587613633 Enrollment ID: I20120306000736 |
| Provider Name | Leta M Whited |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881723732 PECOS PAC ID: 9931242294 Enrollment ID: I20120507000340 |
| Provider Name | Kristin Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972796548 PECOS PAC ID: 0648322420 Enrollment ID: I20120705000328 |
| Provider Name | Samantha D Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982950432 PECOS PAC ID: 2264689884 Enrollment ID: I20120904000140 |
| Provider Name | Priscilla E Mullins |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1447243829 PECOS PAC ID: 8224287784 Enrollment ID: I20120927000565 |
| Provider Name | Jessica L Branham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144537812 PECOS PAC ID: 3577714633 Enrollment ID: I20121119000387 |
| Provider Name | Sarah J Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477896306 PECOS PAC ID: 4183861297 Enrollment ID: I20130509000302 |
| Provider Name | Brandi N May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699112441 PECOS PAC ID: 5092955427 Enrollment ID: I20130709000312 |
| Provider Name | Darla Fowler-ratliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598198087 PECOS PAC ID: 4688808256 Enrollment ID: I20131015000529 |
| Provider Name | Maranda May |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124386453 PECOS PAC ID: 1456581792 Enrollment ID: I20140305001536 |
| Provider Name | Angela M Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114171956 PECOS PAC ID: 8426118100 Enrollment ID: I20140326001673 |
| Provider Name | Erin P Farrar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932526068 PECOS PAC ID: 6800029406 Enrollment ID: I20140506002005 |
| Provider Name | Barbara D Burgy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386752640 PECOS PAC ID: 8628291150 Enrollment ID: I20140602000143 |
| Provider Name | Yasmin Majumder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811305766 PECOS PAC ID: 1254559446 Enrollment ID: I20140829002132 |
| Provider Name | Jennifer J Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205239860 PECOS PAC ID: 0749401594 Enrollment ID: I20141021001727 |
| Provider Name | Neta C Maynard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609287424 PECOS PAC ID: 5890011498 Enrollment ID: I20150225001561 |
| Provider Name | Carolyn Compton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881098754 PECOS PAC ID: 7214256700 Enrollment ID: I20150505001527 |
| Provider Name | Zelda F Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023401866 PECOS PAC ID: 8325367485 Enrollment ID: I20150512001913 |
| Provider Name | Jenny Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427309509 PECOS PAC ID: 7113248717 Enrollment ID: I20150608002681 |
| Provider Name | Layla J Fugate |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699006965 PECOS PAC ID: 4284947839 Enrollment ID: I20150724012083 |
| Provider Name | Peter S Oliver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003131335 PECOS PAC ID: 5395052294 Enrollment ID: I20150909002013 |
| Provider Name | Robin C Bilan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053722793 PECOS PAC ID: 7113228727 Enrollment ID: I20151223000663 |
| Provider Name | Janet Prater |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275640708 PECOS PAC ID: 6204138712 Enrollment ID: I20151230000478 |
| Provider Name | Philip Bloomer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265864425 PECOS PAC ID: 4486947033 Enrollment ID: I20160720001281 |
| Provider Name | Kristen M Henley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316361272 PECOS PAC ID: 0345533436 Enrollment ID: I20160727001151 |
| Provider Name | Carol Grigsby Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346323227 PECOS PAC ID: 7315230331 Enrollment ID: I20160727002324 |
| Provider Name | Kristin J Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427457803 PECOS PAC ID: 3274754734 Enrollment ID: I20160907000995 |
| Provider Name | Courtney Turner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306112552 PECOS PAC ID: 1951540822 Enrollment ID: I20160928001348 |
| Provider Name | Amanda Waddell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306943931 PECOS PAC ID: 8123101862 Enrollment ID: I20161118000983 |
| Provider Name | Tiffanie D Conley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225403207 PECOS PAC ID: 0143509893 Enrollment ID: I20161121000601 |
| Provider Name | Tracy L Rowland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194267898 PECOS PAC ID: 7416238878 Enrollment ID: I20161227001526 |
| Provider Name | Charlene M Benton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124186572 PECOS PAC ID: 8123302932 Enrollment ID: I20170222002458 |
| Provider Name | Angela Damron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720345143 PECOS PAC ID: 7214214709 Enrollment ID: I20170510002612 |
| Provider Name | Richard A Word |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780023465 PECOS PAC ID: 5193968816 Enrollment ID: I20170523000130 |
| Provider Name | Angela D Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356861249 PECOS PAC ID: 6709157977 Enrollment ID: I20170807000753 |
| Provider Name | Stacy W Gilkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740701978 PECOS PAC ID: 7416186416 Enrollment ID: I20170809002342 |
| Provider Name | Charlotte Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164946570 PECOS PAC ID: 9931471430 Enrollment ID: I20170817003296 |
| Provider Name | Jamie Kyzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356625610 PECOS PAC ID: 0143593202 Enrollment ID: I20170912001601 |
| Provider Name | Scott Helm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255535654 PECOS PAC ID: 2668509639 Enrollment ID: I20171027002629 |
| Provider Name | Melissa Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407367493 PECOS PAC ID: 7911263215 Enrollment ID: I20171101003362 |
| Provider Name | Delasaria Lihon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740504174 PECOS PAC ID: 6103184106 Enrollment ID: I20171221000198 |
| Provider Name | Adam Matthew Maggard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700292315 PECOS PAC ID: 0244590198 Enrollment ID: I20180214001234 |
| Provider Name | Bradlee York Burtner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588039168 PECOS PAC ID: 4981966611 Enrollment ID: I20180316002047 |
| Provider Name | Kelly Kelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619362134 PECOS PAC ID: 9537415179 Enrollment ID: I20180711003451 |
| Provider Name | Traci P Cornett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679052864 PECOS PAC ID: 8123379211 Enrollment ID: I20180929000000 |
| Provider Name | Susan B Bowling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437349073 PECOS PAC ID: 2961755707 Enrollment ID: I20181025000616 |
| Provider Name | Evan Jonathan Holcomb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265818520 PECOS PAC ID: 5799038048 Enrollment ID: I20181102001152 |
| Provider Name | Courtney Caudill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386055358 PECOS PAC ID: 0648514901 Enrollment ID: I20181128000792 |
| Provider Name | Lori Humphries |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922423763 PECOS PAC ID: 2668719675 Enrollment ID: I20190129003785 |
| Provider Name | Virgil Ryan Butcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023375656 PECOS PAC ID: 0345589214 Enrollment ID: I20190312000976 |
| Provider Name | Whitney M Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942777933 PECOS PAC ID: 9830422856 Enrollment ID: I20190606001495 |
| Provider Name | Jennifer Oneal Cavins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497856157 PECOS PAC ID: 8426381989 Enrollment ID: I20190614002538 |
| Provider Name | Brandy Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538570148 PECOS PAC ID: 1759610355 Enrollment ID: I20190906002117 |
| Provider Name | Cassie C Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457909046 PECOS PAC ID: 8123358983 Enrollment ID: I20190923000965 |
| Provider Name | Ashely N Cornett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295024297 PECOS PAC ID: 5991967234 Enrollment ID: I20190925002211 |
| Provider Name | Jessica Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174173439 PECOS PAC ID: 3971835307 Enrollment ID: I20191104002178 |
| Provider Name | Stephanie S Brinkerhoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235776899 PECOS PAC ID: 2062847908 Enrollment ID: I20200122002718 |
| Provider Name | Jessica R Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851656169 PECOS PAC ID: 0345676557 Enrollment ID: I20200206003000 |
| Provider Name | Jessica Briggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558982140 PECOS PAC ID: 8527499102 Enrollment ID: I20200514002500 |
| Provider Name | Amelia Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386119410 PECOS PAC ID: 1355772625 Enrollment ID: I20200521000464 |
| Provider Name | Patricia Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790300218 PECOS PAC ID: 0345662391 Enrollment ID: I20200619000516 |
| Provider Name | Devin Hylton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356794291 PECOS PAC ID: 6305269895 Enrollment ID: I20200630002141 |
| Provider Name | Deanna S Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730799560 PECOS PAC ID: 6709202534 Enrollment ID: I20200811002928 |
| Provider Name | Shana Slone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063839876 PECOS PAC ID: 7315365525 Enrollment ID: I20200918001759 |
| Provider Name | Leah Nicole May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073133666 PECOS PAC ID: 6709204977 Enrollment ID: I20200921001489 |
| Provider Name | Lindsay Michelle Burroughs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093321770 PECOS PAC ID: 4486073897 Enrollment ID: I20201005002400 |
| Provider Name | Brooke Leemae Bays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821605387 PECOS PAC ID: 9537579818 Enrollment ID: I20201028002050 |
| Provider Name | Karen Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114528536 PECOS PAC ID: 0143630921 Enrollment ID: I20201105002638 |
| Provider Name | Sarah Jane Worth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295345601 PECOS PAC ID: 9133539844 Enrollment ID: I20201109002660 |
| Provider Name | Autumn Caddell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083166235 PECOS PAC ID: 7911310214 Enrollment ID: I20210105002844 |
| Provider Name | Tyara Lynn Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780097501 PECOS PAC ID: 1153735584 Enrollment ID: I20210127000353 |
| Provider Name | Norresha S Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568817047 PECOS PAC ID: 2961810668 Enrollment ID: I20210419001444 |
| Provider Name | Jennifer M Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932643715 PECOS PAC ID: 9931517307 Enrollment ID: I20210423000972 |
| Provider Name | Andrea Mullins Quillen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851918791 PECOS PAC ID: 4688083843 Enrollment ID: I20210429002150 |
| Provider Name | Amanda Chafins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851973044 PECOS PAC ID: 5799194734 Enrollment ID: I20210504002355 |
| Provider Name | Seema Sachdeva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245293331 PECOS PAC ID: 8921173881 Enrollment ID: I20210511001914 |
| Provider Name | Dawn Luxmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467936252 PECOS PAC ID: 3779982954 Enrollment ID: I20210519002515 |
| Provider Name | Joshua Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346725256 PECOS PAC ID: 9436558806 Enrollment ID: I20210604002301 |
| Provider Name | Ashley Nicole Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780269225 PECOS PAC ID: 4880097393 Enrollment ID: I20210721002672 |
| Provider Name | Laura A Fieser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083188668 PECOS PAC ID: 8527488642 Enrollment ID: I20210722002909 |
| Provider Name | Lorna Isaac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942974282 PECOS PAC ID: 9133523400 Enrollment ID: I20210809002006 |
| Provider Name | Emily E Kyner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215404603 PECOS PAC ID: 0244634343 Enrollment ID: I20210811003814 |
| Provider Name | Hannah Sparks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134599020 PECOS PAC ID: 5395142426 Enrollment ID: I20210916000787 |
| Provider Name | Jessica Lapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700555786 PECOS PAC ID: 7113324989 Enrollment ID: I20210921002042 |
| Provider Name | Charla White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073089942 PECOS PAC ID: 0941608095 Enrollment ID: I20211005000474 |
| Provider Name | Cassidy P Melvin-vice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417537663 PECOS PAC ID: 4486042272 Enrollment ID: I20211027002812 |
| Provider Name | Kathy Jo Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225792971 PECOS PAC ID: 3072901495 Enrollment ID: I20211103002355 |
| Provider Name | Chelsea Workman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174182653 PECOS PAC ID: 5597154179 Enrollment ID: I20211120000203 |
| Provider Name | Paul David Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154088482 PECOS PAC ID: 4587054465 Enrollment ID: I20211208001659 |
| Provider Name | Bethaney Denise Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831229814 PECOS PAC ID: 1850786799 Enrollment ID: I20220311001219 |
| Provider Name | Amelia Kiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982131801 PECOS PAC ID: 5294121877 Enrollment ID: I20220407000832 |
| Provider Name | Julie Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518378348 PECOS PAC ID: 5193111607 Enrollment ID: I20220411001028 |
| Provider Name | Carey Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982054326 PECOS PAC ID: 5092102186 Enrollment ID: I20220419002082 |
| Provider Name | Suzanna Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124594346 PECOS PAC ID: 8224416029 Enrollment ID: I20220607002614 |
| Provider Name | Sheila Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740649607 PECOS PAC ID: 3971800533 Enrollment ID: I20220613000543 |
| Provider Name | Huai Li Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972166841 PECOS PAC ID: 3577942119 Enrollment ID: I20220628001115 |
| Provider Name | Christina Nix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932789492 PECOS PAC ID: 2163802869 Enrollment ID: I20220711003538 |
| Provider Name | Beth Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881274363 PECOS PAC ID: 7618358359 Enrollment ID: I20220713000944 |
| Provider Name | Samantha Gauze |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861125502 PECOS PAC ID: 0648652354 Enrollment ID: I20220727003188 |
| Provider Name | Carla Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073946836 PECOS PAC ID: 2769865203 Enrollment ID: I20220817000868 |
| Provider Name | Jordan Embry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508239070 PECOS PAC ID: 3274918982 Enrollment ID: I20220916000641 |
| Provider Name | Kristi Miracle-maynard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891106613 PECOS PAC ID: 8820473085 Enrollment ID: I20220923002414 |
| Provider Name | Christi Hatfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467947499 PECOS PAC ID: 0244616407 Enrollment ID: I20220926003608 |
| Provider Name | Imani Blunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639657802 PECOS PAC ID: 2163898487 Enrollment ID: I20221011002772 |
| Provider Name | Heather Nicole Bush |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821622275 PECOS PAC ID: 4385010529 Enrollment ID: I20221013001016 |
| Provider Name | Sara Barnard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255815023 PECOS PAC ID: 8729454640 Enrollment ID: I20221018002705 |
| Provider Name | Diana Lynn Herald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043948672 PECOS PAC ID: 2860868551 Enrollment ID: I20221020002596 |
| Provider Name | Darlene Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588120018 PECOS PAC ID: 5294102414 Enrollment ID: I20221101001355 |
| Provider Name | Linzi Antos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124672084 PECOS PAC ID: 1951775709 Enrollment ID: I20230320000453 |
| Provider Name | Preston Jude Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962049171 PECOS PAC ID: 1850756735 Enrollment ID: I20230427002638 |
| Provider Name | Mary Reffitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982143400 PECOS PAC ID: 0840658977 Enrollment ID: I20230622001851 |
| Provider Name | Lakin Michele Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295410512 PECOS PAC ID: 3173984895 Enrollment ID: I20230727003334 |
| Provider Name | Elizabeth Browning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255975629 PECOS PAC ID: 1052784634 Enrollment ID: I20230807001102 |
| Provider Name | Kyndra Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154001840 PECOS PAC ID: 9931561719 Enrollment ID: I20230810001401 |
| Provider Name | Lakin Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467020867 PECOS PAC ID: 4486009503 Enrollment ID: I20231010002300 |
| Provider Name | Jimmy Joshua Mosley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699547851 PECOS PAC ID: 3072961440 Enrollment ID: I20231122002777 |
| Provider Name | Jacqueline Hailey Cardin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083101190 PECOS PAC ID: 0244689636 Enrollment ID: I20231211002158 |
| Provider Name | Laura A. Pearson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518288554 PECOS PAC ID: 7618326687 Enrollment ID: I20231215002189 |
| Provider Name | Sherry Ann Ray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932388618 PECOS PAC ID: 4981054459 Enrollment ID: I20231223000303 |
| Provider Name | Shawn Conn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336599760 PECOS PAC ID: 4385094820 Enrollment ID: I20231227000499 |
| Provider Name | Miriam Marshall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619472453 PECOS PAC ID: 5698125995 Enrollment ID: I20231228003427 |
| Provider Name | Virginia A Stambaugh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922419530 PECOS PAC ID: 8628428620 Enrollment ID: I20240102003752 |
| Provider Name | Jason Scott Bluemlein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124162334 PECOS PAC ID: 5991155962 Enrollment ID: I20240103002488 |
| Provider Name | Rebecca Groves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770911497 PECOS PAC ID: 8325498306 Enrollment ID: I20240103002592 |
| Provider Name | Sasha D Nunemaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083031892 PECOS PAC ID: 3274983267 Enrollment ID: I20240103003214 |
| Provider Name | Laurnea D Vanderpool |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982015467 PECOS PAC ID: 5092166009 Enrollment ID: I20240103003994 |
| Provider Name | Laryn M Shephard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750706412 PECOS PAC ID: 5294186250 Enrollment ID: I20240104000832 |
| Provider Name | Jordan M Steele |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235796921 PECOS PAC ID: 9133570088 Enrollment ID: I20240104004411 |
| Provider Name | Robert Darrell Castle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801807730 PECOS PAC ID: 9335247014 Enrollment ID: I20240105002251 |
| Provider Name | Judy Lawson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720563265 PECOS PAC ID: 4183075914 Enrollment ID: I20240105002756 |
| Provider Name | Tonya Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033498316 PECOS PAC ID: 9739530577 Enrollment ID: I20240105003133 |
| Provider Name | Stephanie C Maggard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639229412 PECOS PAC ID: 7012368863 Enrollment ID: I20240105003481 |
| Provider Name | Ashley N Newman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558761544 PECOS PAC ID: 9739530585 Enrollment ID: I20240105003515 |
| Provider Name | Sherry Horne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114283280 PECOS PAC ID: 8123479847 Enrollment ID: I20240108000597 |
| Provider Name | Morgan Kinslow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982054318 PECOS PAC ID: 3072964709 Enrollment ID: I20240108003243 |
| Provider Name | Lisa B Paxton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730380064 PECOS PAC ID: 1355792938 Enrollment ID: I20240108005103 |
| Provider Name | Jason Ray Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528375565 PECOS PAC ID: 8426409962 Enrollment ID: I20240109001380 |
| Provider Name | Amelia Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659846780 PECOS PAC ID: 3870944317 Enrollment ID: I20240109001413 |
| Provider Name | Katrina Self |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447728233 PECOS PAC ID: 9032560339 Enrollment ID: I20240111001469 |
| Provider Name | Andrea Renee Conn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255846416 PECOS PAC ID: 7911358155 Enrollment ID: I20240111003240 |
| Provider Name | Angela Lynn Collett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861981532 PECOS PAC ID: 2062863228 Enrollment ID: I20240111004238 |
| Provider Name | Rosalind Renee Sheffield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295964575 PECOS PAC ID: 8729439922 Enrollment ID: I20240112000630 |
| Provider Name | Jamie Benjamin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538643317 PECOS PAC ID: 4183075286 Enrollment ID: I20240112001007 |
| Provider Name | Cara L Holley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396220166 PECOS PAC ID: 6305297433 Enrollment ID: I20240112001963 |
| Provider Name | Cassandra Gail Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487139267 PECOS PAC ID: 2769833805 Enrollment ID: I20240112002304 |
| Provider Name | Travis L Copley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306103718 PECOS PAC ID: 2961853049 Enrollment ID: I20240112003357 |
| Provider Name | Rachel Morton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376010751 PECOS PAC ID: 9537510615 Enrollment ID: I20240112003593 |
| Provider Name | Cheryl A Headen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013355833 PECOS PAC ID: 5294186383 Enrollment ID: I20240112003846 |
| Provider Name | Wendy M Hatton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194082420 PECOS PAC ID: 8820449911 Enrollment ID: I20240112003856 |
| Provider Name | Marcella C Ramsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225183288 PECOS PAC ID: 3870945967 Enrollment ID: I20240112004061 |
| Provider Name | Brandt Briggs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164840393 PECOS PAC ID: 6608228606 Enrollment ID: I20240116000405 |
| Provider Name | Mary Ann Herald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902099302 PECOS PAC ID: 3274985221 Enrollment ID: I20240116001968 |
| Provider Name | James Adam Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194209700 PECOS PAC ID: 2466804000 Enrollment ID: I20240118003221 |
| Provider Name | Keila L Fulkerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912446535 PECOS PAC ID: 7517319064 Enrollment ID: I20240119002236 |
| Provider Name | Tasha C Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770841876 PECOS PAC ID: 1052763539 Enrollment ID: I20240119003503 |
| Provider Name | Amy P. Fairchild |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164512547 PECOS PAC ID: 4183077324 Enrollment ID: I20240124002512 |
| Provider Name | Samantha M Preece |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467718635 PECOS PAC ID: 0042663296 Enrollment ID: I20240124002712 |
| Provider Name | Amye R Casebolt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265790372 PECOS PAC ID: 3476906652 Enrollment ID: I20240124003909 |
| Provider Name | Kathy J Vallee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235468497 PECOS PAC ID: 6204289168 Enrollment ID: I20240126001319 |
| Provider Name | Ronald Matthew Harvey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457482457 PECOS PAC ID: 2365895208 Enrollment ID: I20240127000245 |
| Provider Name | Angela M Hall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316450349 PECOS PAC ID: 5991158578 Enrollment ID: I20240131000281 |
| Provider Name | Georgia A Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528414075 PECOS PAC ID: 1153774732 Enrollment ID: I20240131000340 |
| Provider Name | Ronetta A. Tucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174637730 PECOS PAC ID: 9234582701 Enrollment ID: I20240131003686 |
| Provider Name | Lakan Lowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730589425 PECOS PAC ID: 3072956937 Enrollment ID: I20240207002275 |
| Provider Name | Jena Aileen Thacker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386275048 PECOS PAC ID: 3870937824 Enrollment ID: I20240216003807 |
| Provider Name | Ashley Dawn Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407267461 PECOS PAC ID: 0547604555 Enrollment ID: I20240219000440 |
| Provider Name | Robert Darrell Castle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033588785 PECOS PAC ID: 1052756178 Enrollment ID: I20240228003950 |
| Provider Name | Hallie Redden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851155626 PECOS PAC ID: 3274979778 Enrollment ID: I20240306003648 |
| Provider Name | Cassie Marie Graham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962632398 PECOS PAC ID: 2668818477 Enrollment ID: I20240314001556 |
| Provider Name | Richard Phillip Gantt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417174285 PECOS PAC ID: 9830537927 Enrollment ID: I20240409002589 |
| Provider Name | Emily Fryman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790246544 PECOS PAC ID: 6204275118 Enrollment ID: I20240411002334 |
| Provider Name | Sara Fry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336613918 PECOS PAC ID: 8527407063 Enrollment ID: I20240417002098 |
| Provider Name | Kacee Akers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144088766 PECOS PAC ID: 7911348859 Enrollment ID: I20240509002891 |
| Provider Name | Jessica Martinovich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942806583 PECOS PAC ID: 2567803836 Enrollment ID: I20240517000565 |
Kvc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 561 N Lake Dr, Prestonsburg, KY 41653 Phone: 606-216-3268 | |
Highlands Arh Regional Medical Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5000 Ky Route 321, Prestonsburg, KY 41653 Phone: 606-886-8511 | |
Appalachian Behavioral Health Group Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1390 Abbott Creek Rd, Prestonsburg, KY 41653 Phone: 606-879-1397 | |
Highlands Hospital Corp Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5000 Ky Route 321, Prestonsburg, KY 41653 Phone: 606-886-8511 Fax: 606-886-7761 | |
Mountain Health Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3056 Ky Route 321, Prestonsburg, KY 41653 Phone: 606-793-4510 | |
Kvc Behaviorial Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 561 N Lake Dr, Prestonsburg, KY 41653 Phone: 606-216-4186 | |
Ovp Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Oak Ridge Ct Ste 3, Prestonsburg, KY 41653 Phone: 606-889-1602 Fax: 606-263-4467 |