| Dr Jason Southall Orrock, PHD, LPC, NCC | |
|
1030 S Brundidge St, Troy, AL 36081-3121 | |
| (434) 987-3669 | |
| Not Available |
| Full Name | Dr Jason Southall Orrock |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 1030 S Brundidge St, Troy, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881033850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3143 (Alabama) | Primary |
| 101YP2500X | Counselor - Professional | 3143 (Alabama) | Secondary |
| Entity Name | Gardenia Cove Mental Health Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063912301 PECOS PAC ID: 0648534537 Enrollment ID: O20180430002176 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jason Southall Orrock, PHD, LPC, NCC Po Box 1262, Troy, AL 36081-1262 Ph: (434) 987-3669 | Dr Jason Southall Orrock, PHD, LPC, NCC 1030 S Brundidge St, Troy, AL 36081-3121 Ph: (434) 987-3669 |
Michelle Mclendon, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1305 S Brundidge St Ste G, Troy, AL 36081 Phone: 334-770-0421 Fax: 334-770-0422 | |
Mr. Patrick Eugene Hampton, ALC Counselor Medicare: Not Enrolled in Medicare Practice Location: 82 County Road 5501, Troy, AL 36081 Phone: 334-465-5623 | |
Mrs. Mckenzie S Tidwell, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 Cherry Street, Troy, AL 36081 Phone: 334-566-6022 Fax: 334-566-5346 | |
Kawannon Richardson Taylor, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 153 Scouting Cir, Troy, AL 36081 Phone: 334-808-8991 Fax: 334-808-8995 | |
Mrs. Wanda Evette Brown, ALC Counselor Medicare: Not Enrolled in Medicare Practice Location: 153 Scouting Cir, Troy, AL 36081 Phone: 334-464-2164 | |
Mrs. Dixie H. Hollis, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 Cherry Street, Troy, AL 36081 Phone: 334-566-6022 Fax: 334-566-5346 | |
Mrs. Renee Fulmer Daughtry, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 315 N 3notch St, Troy, AL 36081 Phone: 334-372-0346 Fax: 256-701-6926 |