| Mr Kelly Frost, MS, SUDP | |
|
1155 N State St, Bellingham, WA 98225-5037 | |
| (360) 676-4485 | |
| (360) 714-1294 |
| Full Name | Mr Kelly Frost |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1155 N State St, Bellingham, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245788694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 60545681 (Washington) | Primary |
| Entity Name | Illahee Home Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124329669 PECOS PAC ID: 7719374776 Enrollment ID: O20220422000673 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kelly Frost, MS, SUDP 1130 N State St, Bellingham, WA 98225-5014 Ph: (360) 676-4485 | Mr Kelly Frost, MS, SUDP 1155 N State St, Bellingham, WA 98225-5037 Ph: (360) 676-4485 |
Katharine Margaret Botelle Wolhart, MSW, LICSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 410 W. Bakerview Rd. Suite 110, Office 110, Bellingham, WA 98226 Phone: 360-926-5647 | |
Mr. Keith Poynter, Counselor Medicare: Medicare Enrolled Practice Location: 2530 Kwina Rd, Bellingham, WA 98226 Phone: 360-384-2330 Fax: 360-384-3218 | |
Mr. Richard J Evans V, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 600 Lakeway Dr, Bellingham, WA 98225 Phone: 360-676-6749 | |
Hollace Carole Schetrompf, Counselor Medicare: Not Enrolled in Medicare Practice Location: 609 N Shore Dr, Bellingham, WA 98226 Phone: 360-676-6000 | |
Ms. Alison Hastings, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1155 N State St Ste 616, Bellingham, WA 98225 Phone: 360-671-3574 | |
Annalisa Ochiltre, MS Counselor Medicare: Medicare Enrolled Practice Location: 2333 Pacific St, Bellingham, WA 98229 Phone: 360-472-0528 Fax: 360-653-8028 | |
Jaclyn Reynolds, Counselor Medicare: Not Enrolled in Medicare Practice Location: 609 N Shore Dr, Bellingham, WA 98226 Phone: 360-676-6000 |