Miss Trilby Blythe Tuesday Kerrigan, LCSW | |
6991 N State St, Redwood Valley, CA 95470-9629 | |
(707) 234-2503 | |
(707) 485-5199 |
Full Name | Miss Trilby Blythe Tuesday Kerrigan |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 6991 N State St, Redwood Valley, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073011524 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 104756 (California) | Primary |
101YM0800X | Counselor - Mental Health | 78187 (California) | Secondary |
Entity Name | Consolidated Tribal Health Project, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003826009 PECOS PAC ID: 1456260736 Enrollment ID: O20050714000893 |
Mailing Address | Practice Location Address |
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Miss Trilby Blythe Tuesday Kerrigan, LCSW Po Box 465, Ukiah, CA 95482-0465 Ph: (707) 380-4351 | Miss Trilby Blythe Tuesday Kerrigan, LCSW 6991 N State St, Redwood Valley, CA 95470-9629 Ph: (707) 234-2503 |
Stephanie A Piekarski, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 6991 N State St, Redwood Valley, CA 95470 Phone: 707-467-5612 | |
Susan M. Knopf, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6991 N State St, Redwood Valley, CA 95470 Phone: 707-485-5115 Fax: 707-485-1184 |