| Doctor Mays-couch Llc | |
|
1839 Thomas Jeffereson Hwy Charlotte Courthouse VA 23923 | |
| (434) 542-3315 | |
| Not Available |
| Full Name | Doctor Mays-couch Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1839 Thomas Jeffereson Hwy, Charlotte Courthouse, Virginia |
| Authorized Official Name and Position | Shelley Mays-couch (CEO) |
| Authorized Official Contact | 4343151817 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor Mays-couch Llc Po Box 32 Farmville VA 23901-0032 Ph: (434) 542-3315 | Doctor Mays-couch Llc 1839 Thomas Jeffereson Hwy Charlotte Courthouse VA 23923 Ph: (434) 542-3315 |
| NPI Number | 1477296457 |
|---|---|
| Provider Enumeration Date | 04/18/2022 |
| Last Update Date | 04/18/2022 |
| Certification Date | 04/05/2022 |
| Medicare PECOS PAC ID | 2163890260 |
|---|---|
| Medicare Enrollment ID | O20221121003246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477296457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katrina Mansinon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194908079 PECOS PAC ID: 4284794082 Enrollment ID: I20081124000804 |
| Provider Name | Shelley Mays-couch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821547639 PECOS PAC ID: 8224318803 Enrollment ID: I20161219000588 |