| Yadkin County Advp | |
|
3801b River Road Boonville NC 27011-8341 | |
| (336) 367-5187 | |
| (336) 367-3062 |
| Full Name | Yadkin County Advp |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 3801b River Road, Boonville, North Carolina |
| Authorized Official Name and Position | Terri Mikles Vestal (ADVP DIRECTOR) |
| Authorized Official Contact | 33633675187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Yadkin County Advp 121 Washington St Yadkinville NC 27055-7725 Ph: (336) 367-5187 | Yadkin County Advp 3801b River Road Boonville NC 27011-8341 Ph: (336) 367-5187 |
| NPI Number | 1003966383 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003966383 | NPI | - | NPPES |
| 3408907 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | MHL-099-002 (North Carolina) | Primary |
Carolina Residential Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Williams St, Boonville, NC 27011 Phone: 336-367-9039 Fax: 336-367-9039 | |
Country Love Home Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2632 Holcomb Rd, Boonville, NC 27011 Phone: 336-287-0208 | |
Foothills Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 N Carolina Ave, Boonville, NC 27011 Phone: 336-303-0585 |