| Dee Ann Etheridge, LCSW | |
|
1420a S Pollock St, Selma, NC 27576-3404 | |
| (919) 351-0428 | |
| (919) 351-0814 |
| Full Name | Dee Ann Etheridge |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 19 Years |
| Location | 1420a S Pollock St, Selma, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598188740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C007177 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mindpath Care Centers North Carolina Pllc | 4688655517 | 80 |
| Entity Name | Mindpath Care Centers North Carolina Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508803214 PECOS PAC ID: 4688655517 Enrollment ID: O20040526001582 |
| Mailing Address | Practice Location Address |
|---|---|
| Dee Ann Etheridge, LCSW 1420a S Pollock St, Selma, NC 27576-3404 Ph: (919) 351-0428 | Dee Ann Etheridge, LCSW 1420a S Pollock St, Selma, NC 27576-3404 Ph: (919) 351-0428 |
Callie Smith, LCSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 S Pollock St, Selma, NC 27576 Phone: 919-965-6770 | |
Ms. Victoria F. Lucking, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 E Oak St, Selma, NC 27576 Phone: 919-502-9361 | |
Kimberly Davis, LCSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 S Pollock St, Selma, NC 27576 Phone: 919-965-6770 | |
Judith Batamuliza Bushaija, MSW LCSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 S Pollock St, Selma, NC 27576 Phone: 574-360-2226 | |
Ms. Robineta Jovonne Montelina Blackston, LCSW-A Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1420a S Pollock St, Selma, NC 27576 Phone: 919-351-0428 Fax: 919-351-0814 | |
Ashley Smith, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 150 Deer Ridge Dr, Selma, NC 27576 Phone: 252-366-4994 |