| Teresa Obrien-conley, LCSW CADC | |
|
7629 Ky Route 979, Grethel, KY 41631-6304 | |
| (606) 587-2200 | |
| (606) 587-2203 |
| Full Name | Teresa Obrien-conley |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 7629 Ky Route 979, Grethel, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376542746 | NPI | - | NPPES |
| 82000795 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1763 (Kentucky) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0521 (Kentucky) | Secondary |
| Entity Name | Big Sandy Health Care, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104055805 PECOS PAC ID: 1951211218 Enrollment ID: O20040510000841 |
| Entity Name | Big Sandy Health Care, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922594506 PECOS PAC ID: 1951211218 Enrollment ID: O20181008002523 |
| Entity Name | Big Sandy Health Care, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972173136 PECOS PAC ID: 1951211218 Enrollment ID: O20210901001642 |
| Mailing Address | Practice Location Address |
|---|---|
| Teresa Obrien-conley, LCSW CADC 1709 Ky Route 321, Suite 3, Prestonsburg, KY 41653-9097 Ph: (606) 886-8546 | Teresa Obrien-conley, LCSW CADC 7629 Ky Route 979, Grethel, KY 41631-6304 Ph: (606) 587-2200 |
Mr. William T Connelly, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 7629 Ky Route 979, Grethel, KY 41631 Phone: 606-587-2200 Fax: 606-587-2203 |