Julia Lieback, | |
317 Fremont St, West Pittston, PA 18643-2219 | |
(570) 472-8938 | |
Not Available |
Full Name | Julia Lieback |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 317 Fremont St, West Pittston, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154107639 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (Pennsylvania) | Primary |
Entity Name | Thaxton Holistic Wellness Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609243898 PECOS PAC ID: 2769818418 Enrollment ID: O20200129000324 |
Mailing Address | Practice Location Address |
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Julia Lieback, 317 Fremont St, West Pittston, PA 18643-2219 Ph: (570) 472-8938 | Julia Lieback, 317 Fremont St, West Pittston, PA 18643-2219 Ph: (570) 472-8938 |
Mr. Robert Matthew Ross, MS, NCC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 317 Luzerne Ave, West Pittston, PA 18643 Phone: 570-332-2475 Fax: 570-332-2475 | |
Ms. Linda Roseann Benson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 341 Wyoming Ave, Suite #3, West Pittston, PA 18643 Phone: 570-883-9020 Fax: 570-602-7754 | |
Brenda Antonacci, M.S., N.C.C., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 206 Berry St, West Pittston, PA 18643 Phone: 570-407-9810 | |
Shannon M Samuels, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5 Luzerne Ave, West Pittston, PA 18643 Phone: 570-885-8407 |