| Carol Moddelmog, LCMFT | |
|
730 Holly Lane, Salina, KS 67401 | |
| (785) 452-4930 | |
| (785) 452-4932 |
| Full Name | Carol Moddelmog |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 730 Holly Lane, Salina, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588603328 | NPI | - | NPPES |
| 200430380A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 194 (Kansas) | Primary |
| Entity Name | Salina Regional Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619952785 PECOS PAC ID: 0446168215 Enrollment ID: O20040130000800 |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Moddelmog, LCMFT 730 Holly Lane, Salina, KS 67401 Ph: (785) 452-4930 | Carol Moddelmog, LCMFT 730 Holly Lane, Salina, KS 67401 Ph: (785) 452-4930 |
David A Morris, LCMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 730 Holly Lane, Salina, KS 67401 Phone: 785-485-4930 Fax: 785-452-4932 | |
Tara Lynn Pike, TLMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 509 E Elm St, Salina, KS 67401 Phone: 785-825-0541 Fax: 785-825-4024 | |
Esther Victoria Kency, LCMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 809 Elmhurst Blvd, Salina, KS 67401 Phone: 785-823-6322 Fax: 785-823-3109 | |
Mrs. Carolyn Sue Broughton, LCMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 425 W Iron Ave, Salina, KS 67401 Phone: 785-825-0208 Fax: 785-826-9708 | |
Sharris M Nelson-menefee, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 509 E Elm St, Salina, KS 67401 Phone: 785-825-0541 Fax: 785-825-4024 | |
Ms. Danielle Anastashia Blea, T-LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 651 E. Prescott, Salina, KS 67402 Phone: 785-825-7251 Fax: 785-825-6887 | |
Jessica Marie Smith, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 809 Elmhurst Blvd, Salina, KS 67401 Phone: 785-823-6322 Fax: 785-823-3109 |