| Charrisse Leiana Wilson, LCSW | |
|
211 E 1st St, Bloomsburg, PA 17815-1405 | |
| (718) 506-1115 | |
| Not Available |
| Full Name | Charrisse Leiana Wilson |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 211 E 1st St, Bloomsburg, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639853013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Entity Name | Supportive Care Of Pennsylvania Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174992275 PECOS PAC ID: 0143521211 Enrollment ID: O20151214002225 |
| Mailing Address | Practice Location Address |
|---|---|
| Charrisse Leiana Wilson, LCSW 27 Randolph Rd, Howell, NJ 07731-8611 Ph: (718) 506-1115 | Charrisse Leiana Wilson, LCSW 211 E 1st St, Bloomsburg, PA 17815-1405 Ph: (718) 506-1115 |
Michael Spears, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 549 Fair St, Bloomsburg, PA 17815 Phone: 570-387-2432 | |
Ardie Kissinger, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 457 Ridge St, Bloomsburg, PA 17815 Phone: 570-356-2206 | |
Charles Guy Massaro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 29 E Main St, Bloomsburg, PA 17815 Phone: 570-951-6799 | |
Marika Handakas, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 141 Market St, Bloomsburg, PA 17815 Phone: 570-387-8330 | |
Ms. Trudy L Frace, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 816 Central Rd, Bloomsburg, PA 17815 Phone: 570-387-1832 Fax: 570-387-5103 | |
Cindy A Prosseda, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6850 Lowes Road, Bloomsburg, PA 17815 Phone: 570-772-3372 | |
Nicole Iacovoni, LCSW, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 214 Center St, Bloomsburg, PA 17815 Phone: 570-336-9921 |