| Quality Behavioral Health Services, Pllc | |
|
9805 Statesville Rd # 6095 Charlotte NC 28269 | |
| (704) 360-5747 | |
| Not Available |
| Full Name | Quality Behavioral Health Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 9805 Statesville Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Jason Roth (OWNER) |
| Authorized Official Contact | 7043605747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quality Behavioral Health Services, Pllc 9805 Statesville Rd # 6095 Charlotte NC 28269 Ph: () - | Quality Behavioral Health Services, Pllc 9805 Statesville Rd # 6095 Charlotte NC 28269 Ph: (704) 360-5747 |
| NPI Number | 1174089064 |
|---|---|
| Provider Enumeration Date | 02/15/2019 |
| Last Update Date | 04/13/2020 |
| Certification Date | 04/13/2020 |
| Medicare PECOS PAC ID | 2062754427 |
|---|---|
| Medicare Enrollment ID | O20190504000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174089064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Helen Kafer Varnadoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205847324 PECOS PAC ID: 6305949017 Enrollment ID: I20070319000430 |
| Provider Name | Regina C Ingle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134647571 PECOS PAC ID: 8820364391 Enrollment ID: I20171027001679 |
| Provider Name | Jason Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033464052 PECOS PAC ID: 4183907009 Enrollment ID: I20190504000009 |
| Provider Name | Aquicha Renee Duff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558714667 PECOS PAC ID: 0042542557 Enrollment ID: I20191104000892 |
| Provider Name | Rikki Martin Hester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386288256 PECOS PAC ID: 0941634273 Enrollment ID: I20191219001895 |
| Provider Name | Jennifer Danielle Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033577630 PECOS PAC ID: 8022448497 Enrollment ID: I20200427000824 |
| Provider Name | Jasmine Joanne Moore Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295365740 PECOS PAC ID: 1254762107 Enrollment ID: I20200511000844 |
| Provider Name | Ernestine Futrell Webster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831719376 PECOS PAC ID: 8224451505 Enrollment ID: I20200702002278 |
| Provider Name | Madonna Ann Moss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144489808 PECOS PAC ID: 8022437961 Enrollment ID: I20200928000419 |
| Provider Name | Kerry M Dowd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205452448 PECOS PAC ID: 4789088485 Enrollment ID: I20210803001046 |
| Provider Name | Antonia Rover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295211175 PECOS PAC ID: 4082081112 Enrollment ID: I20221102003275 |
| Provider Name | Kourtney Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619225315 PECOS PAC ID: 2264732478 Enrollment ID: I20230106002216 |
| Provider Name | Mary Angela Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891840542 PECOS PAC ID: 9234102427 Enrollment ID: I20230801000743 |
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