| Coalfield Family Services, Pllc | |
|
20824 Route 52 Fort Gay WV 25514-7074 | |
| (304) 648-7100 | |
| (304) 648-7160 |
| Full Name | Coalfield Family Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 20824 Route 52, Fort Gay, West Virginia |
| Authorized Official Name and Position | Danny E Jude (OWNER) |
| Authorized Official Contact | 3046487100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coalfield Family Services, Pllc 20824 Route 52 Fort Gay WV 25514-7074 Ph: (304) 648-7100 | Coalfield Family Services, Pllc 20824 Route 52 Fort Gay WV 25514-7074 Ph: (304) 648-7100 |
| NPI Number | 1811353154 |
|---|---|
| Provider Enumeration Date | 12/31/2015 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Medicare PECOS PAC ID | 0143510909 |
|---|---|
| Medicare Enrollment ID | O20170531001074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811353154 | NPI | - | NPPES |
| Provider Name | Ellen Newhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255882478 PECOS PAC ID: 3072890540 Enrollment ID: I20170531001225 |
| Provider Name | Rebecca Lynn Derossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194375576 PECOS PAC ID: 3577895242 Enrollment ID: I20191030000092 |
| Provider Name | Danny Ernest Jude |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316385792 PECOS PAC ID: 7214247980 Enrollment ID: I20211006002967 |
Valley Health Systems Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 71 Wayne St, Fort Gay, WV 25514 Phone: 304-648-5544 Fax: 304-648-5989 | |
Coalfield Family Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20824 Route 52, Fort Gay, WV 25514 Phone: 304-648-7100 |