| Kenneth Stahl, LPCC-S, LICDC | |
|
4879 Us Highway 68 S, West Liberty, OH 43357 | |
| (937) 599-1411 | |
| (937) 599-4128 |
| Full Name | Kenneth Stahl |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 4879 Us Highway 68 S, West Liberty, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285173179 | NPI | - | NPPES |
| 0213436 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC.161786 (Ohio) | Secondary |
| 101YP2500X | Counselor - Professional | E1700041-SUPV (Ohio) | Primary |
| Entity Name | Community Health & Wellness Partners Of Logan County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689005357 PECOS PAC ID: 8022247469 Enrollment ID: O20140326001589 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Stahl, LPCC-S, LICDC 4879 Us Highway 68 S, West Liberty, OH 43357-9525 Ph: (937) 599-1411 | Kenneth Stahl, LPCC-S, LICDC 4879 Us Highway 68 S, West Liberty, OH 43357 Ph: (937) 599-1411 |
Mr. Timothy Ronald Moebs, CT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1521 North Detroit Street, West Liberty, OH 43357 Phone: 937-465-8065 | |
Marshall J Pierson Iii, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1521 N Detroit St, West Liberty, OH 43357 Phone: 937-465-8065 Fax: 937-465-3505 | |
Janice E Rhoades, LISW LICDC Counselor Medicare: Accepting Medicare Assignments Practice Location: 1521 N Detroit St, West Liberty, OH 43357 Phone: 937-465-8065 Fax: 937-465-3505 | |
Michael K King, LPC LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1521 N Detroit St, West Liberty, OH 43357 Phone: 937-465-8065 Fax: 937-465-3505 |