| Green Meadows Wellness Center One, Llc | |
|
8554 Ky 1232 Corbin KY 40701-6417 | |
| (606) 261-7622 | |
| (606) 261-7312 |
| Full Name | Green Meadows Wellness Center One, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 8554 Ky 1232, Corbin, Kentucky |
| Authorized Official Name and Position | Billy Fitch (BUSINESS MANAGER) |
| Authorized Official Contact | 6063091291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Meadows Wellness Center One, Llc 8554 Ky 1232 Corbin KY 40701-6417 Ph: (606) 261-7622 | Green Meadows Wellness Center One, Llc 8554 Ky 1232 Corbin KY 40701-6417 Ph: (606) 261-7622 |
| NPI Number | 1902377864 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Medicare PECOS PAC ID | 9830434661 |
|---|---|
| Medicare Enrollment ID | O20181221001874 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902377864 | NPI | - | NPPES |
| 7100406190 | Medicaid | KY | |
| 7100606760 | Medicaid | KY | |
| 1720730021 | Medicaid | KY | |
| 7100360730 | Medicaid | KY |
| Provider Name | Sandra J Nantz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194173203 PECOS PAC ID: 9830483387 Enrollment ID: I20160808000367 |
| Provider Name | Christie Arlene Kincaid |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356896898 PECOS PAC ID: 3274893136 Enrollment ID: I20180214001556 |
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