| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 42 Mcginnis Dr, Wayne, West Virginia |
| Authorized Official Name and Position | Mary-beth Brubeck (VICE PRESIDENT OF FINANCE / CFO) |
| Authorized Official Contact | 3045253334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2585 3rd Ave Huntington WV 25703-1642 Ph: (304) 697-1396 | 42 Mcginnis Dr Wayne WV 25570 Ph: (304) 272-5136 |
| NPI Number | 1528038577 |
|---|---|
| Provider Enumeration Date | 01/24/2006 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 9931017969 |
|---|---|
| Medicare Enrollment ID | O20021230000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528038577 | NPI | - | NPPES |
| 2752552 | Medicaid | OH | |
| CJ2698 | Other | WV | RR MEDICARE GROUP |
| 0097245 | Medicaid | OH | |
| 0022945001 | Medicaid | WV | |
| 614938700 | Other | WV | BLACK LUNG |
| 65916702 | Medicaid | KY | |
| 6593967000 | Medicaid | KY |
Michels' Counseling And Consulting Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 A Rt 152, Wayne, WV 25530 Phone: 304-942-0000 |