| Frontier Psychological Associates, L C | |
|
724 Front Street Suite 230 Evanston WV 82930 | |
| (307) 789-6773 | |
| (307) 789-3244 |
| Full Name | Frontier Psychological Associates, L C |
|---|---|
| Speciality | Counselor |
| Location | 724 Front Street, Evanston, West Virginia |
| Authorized Official Name and Position | Juliet L Jett (CO-OWNER) |
| Authorized Official Contact | 3077896773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontier Psychological Associates, L C 724 Front Street Suite 230 Evanston WV 82930 Ph: (307) 789-6773 | Frontier Psychological Associates, L C 724 Front Street Suite 230 Evanston WV 82930 Ph: (307) 789-6773 |
| NPI Number | 1679622393 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 08/29/2022 |
| Certification Date | 08/29/2022 |
| Medicare PECOS PAC ID | 4981664901 |
|---|---|
| Medicare Enrollment ID | O20041014000379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679622393 | NPI | - | NPPES |
| 110414403 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| Provider Name | Denise M Debarre |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912051806 PECOS PAC ID: 1557347382 Enrollment ID: I20040624000736 |
| Provider Name | Pamela R Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053469452 PECOS PAC ID: 0244323566 Enrollment ID: I20070831000642 |
| Provider Name | Cora J Klotzbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356495808 PECOS PAC ID: 3870686199 Enrollment ID: I20070831000644 |
| Provider Name | Juliet L Jett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346398732 PECOS PAC ID: 6800977315 Enrollment ID: I20101021001474 |
| Provider Name | Ryan Paul Hunsaker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558809905 PECOS PAC ID: 6406130681 Enrollment ID: I20170307002368 |
| Provider Name | Julia E Murray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346398724 PECOS PAC ID: 5991886400 Enrollment ID: I20240108005786 |