| Mrs Carol A Henderson, | |
|
30 Technology Dr, Rocky Mount, VA 24151-3008 | |
| (540) 483-5044 | |
| (276) 632-0995 |
| Full Name | Mrs Carol A Henderson |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 14 Years |
| Location | 30 Technology Dr, Rocky Mount, Virginia |
| 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 |
|---|---|---|---|
| 1710331822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701006515 (Virginia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Privia Medical Group, Llc | 4385682061 | 1522 |
| Entity Name | Mark Thomas Mahoney, D.O., P.C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740227156 PECOS PAC ID: 1658337100 Enrollment ID: O20041206001199 |
| Entity Name | Privia Medical Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140603000011 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Carol A Henderson, 24 Clay St, Martinsville, VA 24112-2810 Ph: (276) 632-7128 | Mrs Carol A Henderson, 30 Technology Dr, Rocky Mount, VA 24151-3008 Ph: (540) 483-5044 |
Morgan Lacey Santiago, Counselor Medicare: Not Enrolled in Medicare Practice Location: 370 Tanyard Rd, Rocky Mount, VA 24151 Phone: 540-488-5636 Fax: 888-808-3395 |
Avery E Kerr, L.P.C. Counselor Medicare: Accepting Medicare Assignments Practice Location: 1625 Franklin St, Rocky Mount, VA 24151 Phone: 540-483-9082 |
Challen Marie Mabry, LPC Counselor Medicare: Medicare Enrolled Practice Location: 290 S Main St, Suite 2, Rocky Mount, VA 24151 Phone: 540-483-0312 |
Luke Evan Boone, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 Ruritan Rd, Rocky Mount, VA 24151 Phone: 540-420-6427 |
Courtney Joyce Poage, Counselor Medicare: Not Enrolled in Medicare Practice Location: 370 Tanyard Rd, Rocky Mount, VA 24151 Phone: 540-488-5636 |
Barbara Aileen Fasick, QMHP-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 20 W Court St, Rocky Mount, VA 24151 Phone: 540-482-0164 Fax: 540-264-3096 |
Scott Rutter, Counselor Medicare: Not Enrolled in Medicare Practice Location: 370 Tanyard Rd, Rocky Mount, VA 24151 Phone: 540-488-5636 |