| Colony Behavioral Health Group, Pllc | |
|
2804 Village Way Trent Woods NC 28562-7305 | |
| (252) 636-0112 | |
| (252) 634-9778 |
| Full Name | Colony Behavioral Health Group, Pllc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 2804 Village Way, Trent Woods, North Carolina |
| Authorized Official Name and Position | Bethanne Thumm Jacobson (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2526360112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colony Behavioral Health Group, Pllc 2804 Village Way Trent Woods NC 28562-7305 Ph: (252) 636-0112 | Colony Behavioral Health Group, Pllc 2804 Village Way Trent Woods NC 28562-7305 Ph: (252) 636-0112 |
| NPI Number | 1770536054 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 06/25/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770536054 | NPI | - | NPPES |
| 6006464 | Medicaid | NC | |
| 0197Q | Other | NC | BLUE CROSS BLUE SHEILD |
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