| Mosaic Mental Wellness | |
|
3005 Peters Creek Rd Nw Roanoke VA 24019-2738 | |
| (540) 520-1052 | |
| Not Available |
| Full Name | Mosaic Mental Wellness |
|---|---|
| Speciality | Counselor |
| Location | 3005 Peters Creek Rd Nw, Roanoke, Virginia |
| Authorized Official Name and Position | Deneen Logan Evans (OWNER) |
| Authorized Official Contact | 5405664034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Mental Wellness 3005 Peters Creek Rd Nw Roanoke VA 24019-2738 Ph: (540) 566-4034 | Mosaic Mental Wellness 3005 Peters Creek Rd Nw Roanoke VA 24019-2738 Ph: (540) 520-1052 |
| NPI Number | 1114588241 |
|---|---|
| Provider Enumeration Date | 06/28/2019 |
| Last Update Date | 05/11/2020 |
| Certification Date | 05/11/2020 |
| Medicare PECOS PAC ID | 2062833403 |
|---|---|
| Medicare Enrollment ID | O20200610002687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114588241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Clara S Paynter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144347469 PECOS PAC ID: 4789667734 Enrollment ID: I20040610000689 |
| Provider Name | Eugenia Lindsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730468935 PECOS PAC ID: 5991127607 Enrollment ID: I20200626000186 |
| Provider Name | Deneen Logan Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811579824 PECOS PAC ID: 6608297049 Enrollment ID: I20210720001983 |
| Provider Name | Tara G Barone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881246304 PECOS PAC ID: 0446656391 Enrollment ID: I20210901002279 |
| Provider Name | Deanna Bibby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083274336 PECOS PAC ID: 2062800113 Enrollment ID: I20211022001449 |
| Provider Name | Rachel B Rodgers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710685359 PECOS PAC ID: 7810342193 Enrollment ID: I20231005002384 |
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