| Seneca Health Services, Inc. | |
|
804 Industrial Park Rd Maxwelton WV 24957-8066 | |
| (304) 497-0500 | |
| (304) 497-0516 |
| Full Name | Seneca Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 804 Industrial Park Rd, Maxwelton, West Virginia |
| Authorized Official Name and Position | Marcie L Vaughan (PRESIDENT CEO) |
| Authorized Official Contact | 3048726503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seneca Health Services, Inc. 131 Wellness Dr Summersville WV 26651-5402 Ph: (304) 872-6503 | Seneca Health Services, Inc. 804 Industrial Park Rd Maxwelton WV 24957-8066 Ph: (304) 497-0500 |
| NPI Number | 1154532513 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 04/18/2022 |
| Certification Date | 04/18/2022 |
| Medicare PECOS PAC ID | 8022005263 |
|---|---|
| Medicare Enrollment ID | O20040428001502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154532513 | NPI | - | NPPES |
| 1518953652 | Medicaid | WV | |
| 1245441609 | Medicaid | WV | |
| 1154532513 | Other | MEDICAID CLINIC NPI | |
| 0005478001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 371 (West Virginia) | Primary |
| Provider Name | Katherine M Ball |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639278336 PECOS PAC ID: 8628066743 Enrollment ID: I20040505001218 |
| Provider Name | Patricia A Gore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093875734 PECOS PAC ID: 6305835737 Enrollment ID: I20040510001463 |
| Provider Name | Noel B Jewell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447239520 PECOS PAC ID: 2860469020 Enrollment ID: I20070817000209 |
| Provider Name | Karen L Dotson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093875726 PECOS PAC ID: 4183707839 Enrollment ID: I20080219000171 |
| Provider Name | Wanda S Wyatt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225436884 PECOS PAC ID: 3476872854 Enrollment ID: I20150506002012 |
| Provider Name | Jessica G Shieler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851643597 PECOS PAC ID: 7315189495 Enrollment ID: I20170324001479 |
| Provider Name | Christy M Wickline |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821496548 PECOS PAC ID: 0446577613 Enrollment ID: I20190416001388 |
| Provider Name | Rachel N Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609401520 PECOS PAC ID: 7810310208 Enrollment ID: I20200701001996 |
| Provider Name | Gwendolyn A Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619579315 PECOS PAC ID: 1951713403 Enrollment ID: I20201208000078 |
| Provider Name | Savanna J Babcock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215454699 PECOS PAC ID: 4284900770 Enrollment ID: I20210211001994 |
| Provider Name | Mary Kathleen Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659939387 PECOS PAC ID: 0941537591 Enrollment ID: I20220407000470 |
| Provider Name | Emily Jane Landseidel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629677885 PECOS PAC ID: 8224497839 Enrollment ID: I20230629002511 |
| Provider Name | Jonna R Dahmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093382897 PECOS PAC ID: 7113376021 Enrollment ID: I20231218000340 |
| Provider Name | Christina Lynn Defibaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427754837 PECOS PAC ID: 2466802319 Enrollment ID: I20231219001906 |
| Provider Name | Robert Clayton Bradley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154878346 PECOS PAC ID: 7214388263 Enrollment ID: I20240104000397 |
| Provider Name | Jessica Renee Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821710930 PECOS PAC ID: 3779935648 Enrollment ID: I20240116002843 |
Seneca Health Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 Industrial Park Rd, Maxwelton, WV 24957 Phone: 304-497-0500 Fax: 304-497-0516 | |
Seneca Health Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 Industrial Park Rd, Maxwelton, WV 24957 Phone: 304-497-0500 Fax: 304-497-0516 | |
Seneca Health Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 Industrial Park Rd, Maxwelton, WV 24957 Phone: 304-497-0500 Fax: 304-497-0516 | |
Seneca Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 Industrial Park Rd Ste 1, Maxwelton, WV 24957 Phone: 304-497-0500 Fax: 304-497-0516 |