| Charity Fannin, LCSW | |
|
60 Professional Park Dr, Louisa, KY 41230-9644 | |
| (606) 638-4332 | |
| Not Available |
| Full Name | Charity Fannin |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 60 Professional Park Dr, Louisa, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649725680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 253260 (Kentucky) | Primary |
| Entity Name | Pathways Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982615043 PECOS PAC ID: 1254239171 Enrollment ID: O20031230000043 |
| Mailing Address | Practice Location Address |
|---|---|
| Charity Fannin, LCSW Po Box 790, Ashland, KY 41105-0790 Ph: (606) 329-8588 | Charity Fannin, LCSW 60 Professional Park Dr, Louisa, KY 41230-9644 Ph: (606) 638-4332 |
Tiffany Short, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Eugenia Wilson, CSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Deanna Delores Bolin, CSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 Fax: 859-813-5394 | |
Emily Jones-gray, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Christie Lynn Thomas, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Tiffanie Conley, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Jane Burgess Wallen, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 60 Professional Park Dr, Louisa, KY 41230 Phone: 606-638-4332 Fax: 606-638-4394 |