| Catawba Valley Behavioral Healthcare | |
|
327 1st Ave Nw Hickory NC 28601-6122 | |
| (828) 695-5900 | |
| (828) 695-4256 |
| Full Name | Catawba Valley Behavioral Healthcare |
|---|---|
| Speciality | Counselor |
| Location | 327 1st Ave Nw, Hickory, North Carolina |
| Authorized Official Name and Position | John W Waters (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8286955901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catawba Valley Behavioral Healthcare 327 1st Ave Nw Hickory NC 28601-6122 Ph: (828) 695-5900 | Catawba Valley Behavioral Healthcare 327 1st Ave Nw Hickory NC 28601-6122 Ph: (828) 695-5900 |
| NPI Number | 1962478362 |
|---|---|
| Provider Enumeration Date | 02/24/2006 |
| Last Update Date | 02/14/2019 |
| Medicare PECOS PAC ID | 2264498344 |
|---|---|
| Medicare Enrollment ID | O20041209000941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962478362 | NPI | - | NPPES |
| 016P3 | Other | BCBS INSURANCE | |
| 1015590 | Other | CIGNA INSURANCE | |
| 6005342 | Medicaid | NC | |
| 797098000 | Other | MAGELLAN INSURANCE |
| Provider Name | Lizette S Villacorte |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598780397 PECOS PAC ID: 3870496490 Enrollment ID: I20040130000585 |
| Provider Name | Masood Nmn Mohiuddin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336158351 PECOS PAC ID: 8820043888 Enrollment ID: I20050314000367 |
| Provider Name | John M Waters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396874939 PECOS PAC ID: 9032140736 Enrollment ID: I20050823000310 |
| Provider Name | Lizette D Retis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376519785 PECOS PAC ID: 6103835855 Enrollment ID: I20060407000552 |
| Provider Name | Regina L Whisnant-roper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811024219 PECOS PAC ID: 8628169943 Enrollment ID: I20070801000099 |
| Provider Name | Isabelle H Eustice |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821021080 PECOS PAC ID: 1052446093 Enrollment ID: I20100316000995 |
| Provider Name | Tynecca G Lynch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316262975 PECOS PAC ID: 1759561178 Enrollment ID: I20110202000262 |
| Provider Name | Jeffery Lynn Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295021541 PECOS PAC ID: 8527230903 Enrollment ID: I20111006000484 |
| Provider Name | Thomas E Meek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083713812 PECOS PAC ID: 7618973546 Enrollment ID: I20130212000231 |
| Provider Name | Rudy A Santoso |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023128287 PECOS PAC ID: 7618996117 Enrollment ID: I20130606000760 |
| Provider Name | Umpai Tedrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578791513 PECOS PAC ID: 8921265265 Enrollment ID: I20141215002537 |
| Provider Name | Tammy Fesperman Redmond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730450545 PECOS PAC ID: 4183915978 Enrollment ID: I20160627000623 |
| Provider Name | Francis Sterling Penland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538511225 PECOS PAC ID: 9931497187 Enrollment ID: I20161004001765 |
| Provider Name | Carrie A Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700239522 PECOS PAC ID: 6901194760 Enrollment ID: I20161212001228 |
| Provider Name | Dawn Mcneely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871008649 PECOS PAC ID: 9830459585 Enrollment ID: I20180129001282 |
| Provider Name | Salema Coaxum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487021911 PECOS PAC ID: 4082956537 Enrollment ID: I20190502000454 |
| Provider Name | Jacob W Whitener |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073538195 PECOS PAC ID: 6406282904 Enrollment ID: I20200131001175 |
| Provider Name | Carla S Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174118731 PECOS PAC ID: 3971910472 Enrollment ID: I20210330001166 |
| Provider Name | Kenneth Allen Levesque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730768896 PECOS PAC ID: 0941609531 Enrollment ID: I20210602001378 |
| Provider Name | Ariel H Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366017881 PECOS PAC ID: 7618370289 Enrollment ID: I20210721000299 |
| Provider Name | Courtney M Connolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386301018 PECOS PAC ID: 9931592953 Enrollment ID: I20220215000642 |
| Provider Name | Alicia Buck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649996828 PECOS PAC ID: 0648640797 Enrollment ID: I20230105001788 |
| Provider Name | Thomas Erik Bjorlie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578020855 PECOS PAC ID: 1557711488 Enrollment ID: I20231219001005 |
| Provider Name | Mary Kathleen Collier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689732323 PECOS PAC ID: 0244680833 Enrollment ID: I20231222000024 |
| Provider Name | Sarah Elizabeth Coleman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679600076 PECOS PAC ID: 6800246281 Enrollment ID: I20231227002182 |
| Provider Name | David Phillip Keyes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558478040 PECOS PAC ID: 9133572209 Enrollment ID: I20240125002192 |
| Provider Name | Kay Lynn Bailey-day |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487715082 PECOS PAC ID: 5193178655 Enrollment ID: I20240131003106 |
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