| Ms Lisa Marie Jennings, MSW,QMHP, CSWA, CADC | |
|
11 Sw Brantley Dr, Winston, OR 97496-4526 | |
| (541) 679-0366 | |
| (541) 679-4821 |
| Full Name | Ms Lisa Marie Jennings |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 9 Years |
| Location | 11 Sw Brantley Dr, Winston, Oregon |
| 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 |
|---|---|---|---|
| 1881052876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15-02-24 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Second Wind Mental Health Clinic | 2769792183 | 4 |
| Entity Name | Second Wind Mental Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679957708 PECOS PAC ID: 2769792183 Enrollment ID: O20151113001380 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Lisa Marie Jennings, MSW,QMHP, CSWA, CADC 11 Sw Brantley Dr, Winston, OR 97496-4526 Ph: (541) 679-0366 | Ms Lisa Marie Jennings, MSW,QMHP, CSWA, CADC 11 Sw Brantley Dr, Winston, OR 97496-4526 Ph: (541) 679-0366 |
Mr. Michael Wayne Smith- Fernandez, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 11 Sw Brantley Dr, Winston, OR 97496 Phone: 541-679-0366 Fax: 541-679-4821 | |
Mrs. Heather Amie Jameson, M.S., LMHC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 481 Serengeti Dr, Winston, OR 97496 Phone: 805-535-0484 | |
Lindsay Nicole Merritt, PHD, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 671 Sw Main St, Winston, OR 97496 Phone: 541-492-4550 Fax: 541-492-4556 | |
Ann Carey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 Sw Brantley Dr, Winston, OR 97496 Phone: 541-679-0366 Fax: 541-679-4821 | |
Ronald Bustamante, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 Sw Brantley Dr, Winston, OR 97496 Phone: 541-679-0366 Fax: 541-679-4821 | |
Deborah Ann Dhillon, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 671 Sw Main St, Winston, OR 97496 Phone: 541-672-2691 Fax: 833-299-8415 |