| Josetta Lavonia Sumter-cobb, MA, LPC-I | |
|
1105 Gregg Hwy Nw, Aiken, SC 29801-6341 | |
| (803) 649-1900 | |
| (803) 643-2926 |
| Full Name | Josetta Lavonia Sumter-cobb |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1105 Gregg Hwy Nw, Aiken, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275810467 | NPI | - | NPPES |
| AD01AK | Medicaid | SC | |
| 570569761 | Other | SC | TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 5544 (South Carolina) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 5544 (South Carolina) | Primary |
| Entity Name | Paragon Wellness |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154183499 PECOS PAC ID: 7618419227 Enrollment ID: O20240611002842 |
| Mailing Address | Practice Location Address |
|---|---|
| Josetta Lavonia Sumter-cobb, MA, LPC-I 1105 Gregg Hwy Nw, Aiken, SC 29801-6341 Ph: (803) 649-1900 | Josetta Lavonia Sumter-cobb, MA, LPC-I 1105 Gregg Hwy Nw, Aiken, SC 29801-6341 Ph: (803) 649-1900 |
Katrina Green, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1135 Gregg Hwy Nw, Aiken, SC 29801 Phone: 803-641-7700 | |
Darby A Royal, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1135 Gregg Hwy Nw, Aiken, SC 29801 Phone: 803-641-7700 | |
Gabrielle Torres, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1135 Gregg Hwy, Aiken, SC 29801 Phone: 803-641-7700 | |
Matthew Tyra, LPC Counselor Medicare: Medicare Enrolled Practice Location: 33 Varden Dr, Aiken, SC 29803 Phone: 803-642-3980 | |
Samantha Tierra Gray, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1135 Gregg Hwy Nw, Aiken, SC 29801 Phone: 803-641-7700 | |
Christy Ann Austin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 156 Charleston Row Blvd, Aiken, SC 29803 Phone: 419-376-6291 | |
Jennifer Reed Minichan, M.S., ED.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1000 Brookhaven Dr, Aiken, SC 29803 Phone: 803-641-2624 |