| Theresa M Ivey, LCSW | |
|
860 Lynn St, Lebanon, MO 65536-3810 | |
| (844) 853-8937 | |
| Not Available |
| Full Name | Theresa M Ivey |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 860 Lynn St, Lebanon, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457714628 | NPI | - | NPPES |
| 1457714628 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11372 (Louisiana) | Secondary |
| 1041C0700X | Social Worker - Clinical | 2023044583 (Missouri) | Primary |
| Entity Name | Delta Health Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871193649 PECOS PAC ID: 7911373402 Enrollment ID: O20221025002618 |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa M Ivey, LCSW 1800 Community, Clinton, MO 64735-8804 Ph: (844) 853-8937 | Theresa M Ivey, LCSW 860 Lynn St, Lebanon, MO 65536-3810 Ph: (844) 853-8937 |
Dr. Thomas Edward Patterson Jr., PH.D. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 211 South Washington, Lebanon, MO 65536 Phone: 573-368-3261 Fax: 573-596-0537 | |
Mrs. Danielle L Boggs, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 331 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6369 | |
Lori Torres, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 860 Lynn St, Lebanon, MO 65536 Phone: 888-403-1071 | |
Ms. Michelle Rene' Jackson, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 24728 Falcon Rd, Lebanon, MO 65536 Phone: 417-622-8472 Fax: 417-588-4296 | |
Katie Powell, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 860 Lynn St, Lebanon, MO 65536 Phone: 888-403-1071 | |
Brittney Marie Rufkahr, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 860 Lynn St, Lebanon, MO 65536 Phone: 844-853-8937 |