| Mr Anthony Miller, LCSW | |
|
1599 Jones Street, Grand Forks Afb, ND 58205 | |
| (701) 747-4460 | |
| Not Available |
| Full Name | Mr Anthony Miller |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 1599 Jones Street, Grand Forks Afb, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700326634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 0904009806 (Virginia) | Primary |
| Entity Name | Gordon Wellness Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376928101 PECOS PAC ID: 9638602899 Enrollment ID: O20241025002147 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Anthony Miller, LCSW 1599 Jones Street, Grand Forks Afb, ND 58205 Ph: (701) 747-4460 | Mr Anthony Miller, LCSW 1599 Jones Street, Grand Forks Afb, ND 58205 Ph: (701) 747-4460 |
Janet Nelson, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1599 J St, Grand Forks Afb, ND 58205 Phone: 701-747-6806 Fax: 701-747-7340 | |
Timothy Kresien, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1599 J St, Grand Forks Afb, ND 58205 Phone: 701-747-4460 | |
Mrs. Cara Leigh Grausam, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 319 Medical Group, Mental Health Clinic, Grand Forks Afb, ND 58204 Phone: 701-747-4460 | |
Mrs. Marie Elyse Corbin, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1599 J St, Grand Forks Afb, ND 58205 Phone: 701-747-5547 Fax: 701-747-5469 | |
Ms. Laine Maren Gordon, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1599 J St, Grand Forks Afb, ND 58205 Phone: 701-747-6463 |