| Mrs Chaney Carlucci, LPC | |
|
1414 Cherry St, Vicksburg, MS 39180-3218 | |
| (601) 636-5703 | |
| (601) 636-5739 |
| Full Name | Mrs Chaney Carlucci |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1414 Cherry St, Vicksburg, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477009207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1999 (Mississippi) | Primary |
| Entity Name | Right Track Medical Group, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972080257 PECOS PAC ID: 8729403415 Enrollment ID: O20200728003297 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Chaney Carlucci, LPC 1117 Washington St Apt A, Vicksburg, MS 39183-2959 Ph: (601) 479-6156 | Mrs Chaney Carlucci, LPC 1414 Cherry St, Vicksburg, MS 39180-3218 Ph: (601) 636-5703 |
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: Medicare Enrolled Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739 |