Tammy Blaich, | |
3751 W Main St, Independence, KS 67301-8446 | |
(620) 331-1748 | |
Not Available |
Full Name | Tammy Blaich |
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Gender | Female |
Speciality | Psychologist |
Location | 3751 W Main St, Independence, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801992730 | NPI | - | NPPES |
200441290A | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 039 (Kansas) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | LCAC 523 (Kansas) | Secondary |
Entity Name | Four County Mental Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841290251 PECOS PAC ID: 7012904071 Enrollment ID: O20040430000887 |
Mailing Address | Practice Location Address |
---|---|
Tammy Blaich, Po Box 688, Independence, KS 67301-0688 Ph: () - | Tammy Blaich, 3751 W Main St, Independence, KS 67301-8446 Ph: (620) 331-1748 |
Chelsey Friedrich, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Ginger Hill, Psychologist Medicare: Medicare Enrolled Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Ronald Denney, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Hans Haltom, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Mrs. Tessie Grace Horning, LMLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 Fax: 620-332-1940 | |
Monica Beard, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Judy Wilkins, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 |