|
| |
|
1400 Seafarer Dr Oriental NC 28571-9651 | |
| (434) 392-5005 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1400 Seafarer Dr, Oriental, North Carolina |
| Authorized Official Name and Position | Patricia Miller Thorne (OWNER) |
| Authorized Official Contact | 4343925005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1400 Seafarer Dr Oriental NC 28571-9651 Ph: (434) 392-5005 | 1400 Seafarer Dr Oriental NC 28571-9651 Ph: (434) 392-5005 |
| NPI Number | 1720448350 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 05/28/2024 |
| Certification Date | 05/28/2024 |
| Medicare PECOS PAC ID | 3274978150 |
|---|---|
| Medicare Enrollment ID | O20240301000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720448350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia Thorne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861532566 PECOS PAC ID: 4486758422 Enrollment ID: I20240301001055 |
Guided By Grace Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 711 Broad St, Oriental, NC 28571 Phone: 304-642-1135 |