| Central Avenue Wellness | |
|
652 Central Ave Barboursville WV 25504-1314 | |
| (304) 638-2564 | |
| Not Available |
| Full Name | Central Avenue Wellness |
|---|---|
| Speciality | Counselor |
| Location | 652 Central Ave, Barboursville, West Virginia |
| Authorized Official Name and Position | Melody G Frye (OWNER) |
| Authorized Official Contact | 3046382564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Avenue Wellness 652 Central Ave Barboursville WV 25504-1314 Ph: (304) 638-2564 | Central Avenue Wellness 652 Central Ave Barboursville WV 25504-1314 Ph: (304) 638-2564 |
| NPI Number | 1396483731 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/25/2022 |
| Certification Date | 05/25/2022 |
| Medicare PECOS PAC ID | 4587009568 |
|---|---|
| Medicare Enrollment ID | O20240229001806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396483731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Melody G. Frye |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932279452 PECOS PAC ID: 5496190472 Enrollment ID: I20240229002078 |
| Provider Name | Donna Hardy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205292786 PECOS PAC ID: 7113362047 Enrollment ID: I20240229003844 |
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