Southwest Virginia Child Development Services Corp | |
142 W Jackson St # 101 Gate City VA 24251-2929 | |
(276) 386-2534 | |
(276) 386-2535 |
Full Name | Southwest Virginia Child Development Services Corp |
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Speciality | Psychologist |
Location | 142 W Jackson St # 101, Gate City, Virginia |
Authorized Official Name and Position | Micahel C Mcdonough (LICENSED CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 2763862534 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southwest Virginia Child Development Services Corp 142 W Jackson St # 101 Gate City VA 24251-2929 Ph: (276) 386-2534 | Southwest Virginia Child Development Services Corp 142 W Jackson St # 101 Gate City VA 24251-2929 Ph: (276) 386-2534 |
NPI Number | 1982333167 |
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Provider Enumeration Date | 06/06/2022 |
Last Update Date | 08/29/2022 |
Certification Date | 08/29/2022 |
Medicare PECOS PAC ID | 9830578905 |
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Medicare Enrollment ID | O20220621000033 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982333167 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Michael C Mcdonough |
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Provider Type | Practitioner - Psychologist Billing Independently |
Provider Identifiers | NPI Number: 1689960221 PECOS PAC ID: 0941469506 Enrollment ID: I20120913000444 |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 Jones Street, Gate City, VA 24251 Phone: 246-431-7214 Fax: 276-431-7215 | |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Grover Cleveland Ln, Gate City, VA 24251 Phone: 276-431-7214 Fax: 276-431-7215 | |
Southwest Virginia Child Development Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 142 W Jackson St, Suite 101, Gate City, VA 24251 Phone: 276-386-2535 | |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 135 Beech Street, Gate City, VA 24251 Phone: 276-431-7214 Fax: 276-431-7215 | |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 Municipal Ave, Gate City, VA 24251 Phone: 276-431-7214 Fax: 276-431-7215 | |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Shoemaker Dr, Gate City, VA 24251 Phone: 276-431-7214 | |
Family Preservation Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 248 E Jackson St, Gate City, VA 24251 Phone: 276-431-7214 Fax: 276-431-7215 |