| Lynette M Mccorkle, LPC | |
|
3144 Vanzile Road, Crandon, WI 54520-8149 | |
| (715) 478-5180 | |
| (715) 478-5904 |
| Full Name | Lynette M Mccorkle |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 14 Years |
| Location | 3144 Vanzile Road, Crandon, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609115682 | NPI | - | NPPES |
| 100028082 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5471-125 (Wisconsin) | Secondary |
| 101YM0800X | Counselor - Mental Health | 5471 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sokaogon Chippewa Community | 1759370869 | 10 |
| Entity Name | Sokaogon Chippewa Community |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033115456 PECOS PAC ID: 1759370869 Enrollment ID: O20040512000238 |
| Mailing Address | Practice Location Address |
|---|---|
| Lynette M Mccorkle, LPC 3144 Vanzile Road, Crandon, WI 54520-8149 Ph: (715) 478-5180 | Lynette M Mccorkle, LPC 3144 Vanzile Road, Crandon, WI 54520-8149 Ph: (715) 478-5180 |
James Seymour, CSW/CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4332 | |
Jennifer Krzmarcik, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4370 | |
David Rynearson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4300 | |
Karen A Minx, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3144 Vanzile Road, Crandon, WI 54520 Phone: 715-478-5180 Fax: 715-478-5904 | |
Nicholas Bolte, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4300 | |
Diane M Baird, LICENSED PROFESSIONA Counselor Medicare: Accepting Medicare Assignments Practice Location: 3163 State Hwy 55, Crandon, WI 54520 Phone: 715-478-5180 Fax: 715-478-5904 | |
Jolene A Derfus, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3144 Vanzile Rd, Crandon, WI 54520 Phone: 715-478-5180 |