| Midwest Country Clinic Llc | |
|
801 S State St Bassett NE 68714-5062 | |
| (866) 757-3853 | |
| Not Available |
| Full Name | Midwest Country Clinic Llc |
|---|---|
| Speciality | Counselor |
| Location | 801 S State St, Bassett, Nebraska |
| Authorized Official Name and Position | Melissa Dearmont (OWNER) |
| Authorized Official Contact | 8667573853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Country Clinic Llc Po Box 129 Burwell NE 68823-0129 Ph: () - | Midwest Country Clinic Llc 801 S State St Bassett NE 68714-5062 Ph: (866) 757-3853 |
| NPI Number | 1417155433 |
|---|---|
| Provider Enumeration Date | 07/11/2007 |
| Last Update Date | 10/05/2015 |
| Medicare PECOS PAC ID | 2466768809 |
|---|---|
| Medicare Enrollment ID | O20150901000445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417155433 | NPI | - | NPPES |
| 85517 | Other | NE | BC/BS |
| 100264272-00 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 257 (Nebraska) | Primary |
| Provider Name | Melissa L Dearmont |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922057868 PECOS PAC ID: 6305870197 Enrollment ID: I20050921000602 |
| Provider Name | Kathy A Schindler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326077827 PECOS PAC ID: 7012920341 Enrollment ID: I20060804000273 |
| Provider Name | Jane A Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093962102 PECOS PAC ID: 4880760271 Enrollment ID: I20080909000431 |
| Provider Name | Roxanne O'neill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215145917 PECOS PAC ID: 3375714934 Enrollment ID: I20110913000083 |
| Provider Name | Konni K Kluender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982046363 PECOS PAC ID: 8224263272 Enrollment ID: I20131028001479 |
| Provider Name | Murlene N Osburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788531 PECOS PAC ID: 8224343520 Enrollment ID: I20150817000225 |
| Provider Name | Celianne Bacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588265615 PECOS PAC ID: 4789096470 Enrollment ID: I20201222002498 |
| Provider Name | Sally Davis-jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225672371 PECOS PAC ID: 5799128849 Enrollment ID: I20240206002985 |
| Provider Name | Amber L Keefe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174181804 PECOS PAC ID: 7618313479 Enrollment ID: I20240314003408 |