| Justin Washington, | |
|
2434 S Eason Blvd, Tupelo, MS 38804-6942 | |
| (662) 640-4595 | |
| (662) 680-6416 |
| Full Name | Justin Washington |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 2434 S Eason Blvd, Tupelo, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740800432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2939 (Mississippi) | Primary |
| Entity Name | Chase Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295628105 PECOS PAC ID: 2769950492 Enrollment ID: O20260511002844 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Washington, 2434 S Eason Blvd, Tupelo, MS 38804-6942 Ph: (662) 640-4595 | Justin Washington, 2434 S Eason Blvd, Tupelo, MS 38804-6942 Ph: (662) 640-4595 |
Tiffany Brown, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 Fax: 662-680-6416 |
Alyssa Bridges, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 |
Caitlyn Capps, M.S.,NCC,LPC/MHSP-T Counselor Medicare: May Accept Medicare Assignments Practice Location: Po Box 2792, Tupelo, MS 38803 Phone: 731-472-0395 |
Centrell Gardner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 |
Kayla Harris, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-810-4125 |
Keyaira Standifer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 |
Katelyn Seiler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 |