| Jessica Vandevelde Moreno, LMFT | |
|
601 Virginia Ave N Ste 1, Tifton, GA 31794-4268 | |
| (229) 233-7992 | |
| Not Available |
| Full Name | Jessica Vandevelde Moreno |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 601 Virginia Ave N Ste 1, Tifton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285151175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Entity Name | Vandevelde Moreno And Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356978118 PECOS PAC ID: 9931648763 Enrollment ID: O20240826000564 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Vandevelde Moreno, LMFT Po Box 1089, Omega, GA 31775-1089 Ph: (229) 392-5273 | Jessica Vandevelde Moreno, LMFT 601 Virginia Ave N Ste 1, Tifton, GA 31794-4268 Ph: (229) 233-7992 |
Mrs. Terri Jeaniene Funk, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 601 Virginia Ave N Ste 1, Tifton, GA 31794 Phone: 229-396-5507 | |
Mrs. Erin Nicole Whitley, Couples Therapy Medicare: Medicare Enrolled Practice Location: 601 Virginia Ave N Ste 1, Tifton, GA 31794 Phone: 229-396-5507 | |
Tyundreya Lindsey, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 334 Tifton Eldorado Rd, Tifton, GA 31794 Phone: 229-391-2359 | |
Erica Arambulo, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 106 4th St W, Tifton, GA 31794 Phone: 229-445-3152 Fax: 229-445-3153 |