| Miriam Bond, | |
|
3444 Wisconsin Ave, Vicksburg, MS 39180-5331 | |
| (630) 638-0031 | |
| Not Available |
| Full Name | Miriam Bond |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 19 Years |
| Location | 3444 Wisconsin Ave, Vicksburg, Mississippi |
| 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 |
|---|---|---|---|
| 1366864134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Uppal Medical Center Llc | 4587998547 | 129 |
| Mdb Behavioral Health Services Llc | 0749572915 | 201 |
| Entity Name | Minor Med Care, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407968738 PECOS PAC ID: 7618866021 Enrollment ID: O20040313000147 |
| Entity Name | Mdb Behavioral Health Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669835310 PECOS PAC ID: 0749572915 Enrollment ID: O20160708000104 |
| Entity Name | Uppal Medical Center LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558927905 PECOS PAC ID: 4587998547 Enrollment ID: O20190625001406 |
| Entity Name | Mdb Care Management LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144925272 PECOS PAC ID: 0547619512 Enrollment ID: O20231215002106 |
| Mailing Address | Practice Location Address |
|---|---|
| Miriam Bond, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: Not Available | Miriam Bond, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (630) 638-0031 |
Kaila Virgil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3334 Wisconsin Ave., Vicksburg, MS 39180 Phone: 601-638-0031 |
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 |
Felicia Wilson, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 |
Heather Potts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 |
Rosalyn Glascoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 |
Ann Nelson, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 |
Mr. Walter Lee Frazier, MCP, LPC, NCC Counselor Medicare: Accepting Medicare Assignments Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739 |