| Eileen Velasquez-walters, LCSW | |
|
2 Dewitt St # 10, Jacksonville, NC 28540-5649 | |
| (910) 939-1127 | |
| (574) 546-1999 |
| Full Name | Eileen Velasquez-walters |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 2 Dewitt St # 10, Jacksonville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720558901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34008105A (Indiana) | Primary |
| Entity Name | Open Water Wellness Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437834942 PECOS PAC ID: 0941664114 Enrollment ID: O20230907000967 |
| Mailing Address | Practice Location Address |
|---|---|
| Eileen Velasquez-walters, LCSW 2 Dewitt St # 10, Jacksonville, NC 28540-5649 Ph: () - | Eileen Velasquez-walters, LCSW 2 Dewitt St # 10, Jacksonville, NC 28540-5649 Ph: (910) 939-1127 |
Jessica Smith, MSW,LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 215 Memorial Dr, Jacksonville, NC 28546 Phone: 910-353-5118 | |
Amanda Ashley Manning, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Tarpon Trl, Jacksonville, NC 28546 Phone: 910-938-1114 Fax: 910-938-1118 | |
Elise Cowart, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 445 Western Blvd Ste Q, Jacksonville, NC 28546 Phone: 910-858-5848 | |
Portia Adams, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 110 Branchwood Dr Ste B, Jacksonville, NC 28546 Phone: 910-938-9833 | |
Ms. Tatianna Brooks, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 231 New Bridge St, Jacksonville, NC 28540 Phone: 910-915-9155 Fax: 910-939-5484 | |
Nicole Marie Polidoro, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Tarpon Trl, Jacksonville, NC 28546 Phone: 910-938-1114 Fax: 910-938-1118 | |
Shirby Durant, LCSWA, LCASA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 231 Memorial Dr, Jacksonville, NC 28546 Phone: 910-353-5354 |