Pamela J Wharton, Llc | |
3897 N 20th St Ste 1 Ozark MO 65721-8522 | |
(417) 770-2901 | |
Not Available |
Full Name | Pamela J Wharton, Llc |
---|---|
Speciality | Counselor |
Location | 3897 N 20th St Ste 1, Ozark, Missouri |
Authorized Official Name and Position | Pamela Wharton (OWNER/LPC) |
Authorized Official Contact | 4177702901 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pamela J Wharton, Llc 3897 N 20th St Ste 1 Ozark MO 65721-8522 Ph: (417) 770-2901 | Pamela J Wharton, Llc 3897 N 20th St Ste 1 Ozark MO 65721-8522 Ph: (417) 770-2901 |
NPI Number | 1700652005 |
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Provider Enumeration Date | 11/28/2023 |
Last Update Date | 11/28/2023 |
Certification Date | 11/28/2023 |
Medicare PECOS PAC ID | 9931545159 |
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Medicare Enrollment ID | O20240311002325 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700652005 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Pamela Jean Wharton |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1083047690 PECOS PAC ID: 3577909795 Enrollment ID: I20240311002384 |
Provider Name | Harry Kevin Wade |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1619520368 PECOS PAC ID: 8527404748 Enrollment ID: I20240311002483 |
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