| Ms Melissa Jane Hansford, LPCC | |
|
109 S 4th St Ste 2, Williamsburg, KY 40769-1221 | |
| (606) 304-7994 | |
| Not Available |
| Full Name | Ms Melissa Jane Hansford |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 109 S 4th St Ste 2, Williamsburg, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356700710 | NPI | - | NPPES |
| 242650 | Other | KY | STATE LICENSE |
| 7100566260 | Medicaid | KY | |
| LPC4786 | Other | TN | STATE LICENSE |
| Q047626 | Medicaid | TN |
| Entity Name | Southern Roots Therapeutic Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851155014 PECOS PAC ID: 5395184717 Enrollment ID: O20240418001943 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Melissa Jane Hansford, LPCC 74 Falin Ln, Williamsburg, KY 40769-1791 Ph: (606) 304-7994 | Ms Melissa Jane Hansford, LPCC 109 S 4th St Ste 2, Williamsburg, KY 40769-1221 Ph: (606) 304-7994 |
Lyndsay Erin Baker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 386 Brush Arbor Rd, Williamsburg, KY 40769 Phone: 606-215-6173 | |
Hannah Ruth Stephens, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1047 S Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-2656 | |
Ms. Tarah Jean Kidd, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-0123 | |
Sarah Patricia Cloud, Counselor Medicare: Not Enrolled in Medicare Practice Location: 76 Wilson Rd, Williamsburg, KY 40769 Phone: 606-304-2499 | |
Ms. Jessica R Noe, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 1047 S Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-2656 | |
Brittany Manus, Counselor Medicare: Not Enrolled in Medicare Practice Location: 285 Cemetery Rd, Williamsburg, KY 40769 Phone: 606-549-1440 |