| Jw Counseling Pllc | |
|
2485 N Nc 16 Business Hwy Ste 100 Denver NC 28037-8256 | |
| (704) 530-8341 | |
| Not Available |
| Full Name | Jw Counseling Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2485 N Nc 16 Business Hwy Ste 100, Denver, North Carolina |
| Authorized Official Name and Position | Jessie Amber Watts Gogg (OWNER) |
| Authorized Official Contact | 7045308341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jw Counseling Pllc 2485 N Nc 16 Business Hwy Ste 100 Denver NC 28037-8256 Ph: (704) 530-8341 | Jw Counseling Pllc 2485 N Nc 16 Business Hwy Ste 100 Denver NC 28037-8256 Ph: (704) 530-8341 |
| NPI Number | 1063279578 |
|---|---|
| Provider Enumeration Date | 03/01/2024 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Medicare PECOS PAC ID | 7810336096 |
|---|---|
| Medicare Enrollment ID | O20240421000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063279578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jessie Watts Gogg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801317383 PECOS PAC ID: 8729427901 Enrollment ID: I20240421000055 |
| Provider Name | Kendal Kae Blackwelder Gulledge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447655634 PECOS PAC ID: 6002333143 Enrollment ID: I20250512002319 |
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