Charles Lawson Bost, | |
1401 Applewood Dr, Dalton, GA 30720-2699 | |
(706) 270-5033 | |
Not Available |
Full Name | Charles Lawson Bost |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 1401 Applewood Dr, Dalton, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013381284 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | MFT001659 (Georgia) | Secondary |
101YP2500X | Counselor - Professional | LPC013145 (Georgia) | Primary |
Entity Name | Personal Recovery Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096 |
Mailing Address | Practice Location Address |
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Charles Lawson Bost, 1725 Edenburg Way, Evans, GA 30809-8423 Ph: (706) 506-2624 | Charles Lawson Bost, 1401 Applewood Dr, Dalton, GA 30720-2699 Ph: (706) 270-5033 |
Ms. Leslie Suttle, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1401 Applewood, Dalton, GA 30720 Phone: 706-270-5033 | |
Caitlin Mariah Johnson, LPC, CRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1414 Dug Gap Rd, Dalton, GA 30720 Phone: 706-279-0405 | |
Marixa Ortiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 Shugart Rd, Dalton, GA 30720 Phone: 706-270-5005 | |
Estina Beth Vice, LAPC Counselor Medicare: Medicare Enrolled Practice Location: 900 Shugart Rd, Dalton, GA 30720 Phone: 706-270-5100 Fax: 706-270-5066 | |
Kayeeshia Morris, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1414 Dug Gap Rd, Dalton, GA 30720 Phone: 706-279-0405 | |
Chelsea Elrod, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2615 Cleveland Hwy, Dalton, GA 30721 Phone: 706-270-5050 | |
Damaris Natola, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1708 Oakmont Dr, Dalton, GA 30720 Phone: 423-596-1244 |