Richard Mark States, MA, LPC | |
533 Maple Ave, Du Bois, PA 15801-2311 | |
(814) 771-7264 | |
Not Available |
Full Name | Richard Mark States |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 533 Maple Ave, Du Bois, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194795302 | NPI | - | NPPES |
001767829 | Other | PA | HIGHMARK BC/BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | PL002948 (Pennsylvania) | Primary |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220512002242 |
Mailing Address | Practice Location Address |
---|---|
Richard Mark States, MA, LPC 533 Maple Ave, Du Bois, PA 15801-2311 Ph: (814) 771-7264 | Richard Mark States, MA, LPC 533 Maple Ave, Du Bois, PA 15801-2311 Ph: (814) 771-7264 |
Elaine M. Boal, B. A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Caldwell Dr, Du Bois, PA 15801 Phone: 814-371-1100 | |
Pamela S Brunelli, Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Caldwell Dr, Du Bois, PA 15801 Phone: 814-371-1100 Fax: 814-375-0120 | |
Letasha Anne Tedrow, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Caldwell Dr, Du Bois, PA 15801 Phone: 814-371-1100 Fax: 814-375-0120 | |
Melissa Lynn Baird, B. S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Caldwell Dr, Du Bois, PA 15801 Phone: 814-371-1100 | |
Shannon L Lucas, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Caldwell Dr, Du Bois, PA 15801 Phone: 814-371-1100 Fax: 814-371-3671 | |
Ms. Tara Leigh Collins, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Caldwell Dr, Du Bois, PA 15801 Phone: 814-371-1100 Fax: 814-375-0120 | |
Shannon R Lange, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 S Brady St Ste 205, Du Bois, PA 15801 Phone: 814-371-1088 Fax: 814-371-4966 |