Christine A Dyer, LISW-S | |
1302 W Main St Ste A, Louisville, OH 44641-1114 | |
(330) 875-5544 | |
(330) 875-8150 |
Full Name | Christine A Dyer |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1302 W Main St Ste A, Louisville, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639121668 | NPI | - | NPPES |
0183464 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | I.0030945 (Ohio) | Secondary |
1041C0700X | Social Worker - Clinical | 1.0030945-SUPV (Ohio) | Primary |
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210316002509 |
Mailing Address | Practice Location Address |
---|---|
Christine A Dyer, LISW-S 625 Cleveland Ave Nw, Canton, OH 44702-1805 Ph: (330) 453-8252 | Christine A Dyer, LISW-S 1302 W Main St Ste A, Louisville, OH 44641-1114 Ph: (330) 875-5544 |
Michaela Ann Huston, MSW, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1293 California Ave Unit A, Louisville, OH 44641 Phone: 330-303-1182 | |
Mallory Linder, LISW-S Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7001 N Nickelplate St, Louisville, OH 44641 Phone: 614-296-2378 |