| Williamson Health & Wellness Center Inc | |
|
104 Logan St Ste B Williamson WV 25661-3606 | |
| (304) 236-5902 | |
| (855) 487-4047 |
| Full Name | Williamson Health & Wellness Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 Logan St Ste B, Williamson, West Virginia |
| Authorized Official Name and Position | Christopher Donovan Beckett (CEO) |
| Authorized Official Contact | 3042365902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Williamson Health & Wellness Center Inc Po Box 2080 Williamson WV 25661-2080 Ph: (304) 236-5902 | Williamson Health & Wellness Center Inc 104 Logan St Ste B Williamson WV 25661-3606 Ph: (304) 236-5902 |
| NPI Number | 1942840384 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Medicare PECOS PAC ID | 5395972996 |
|---|---|
| Medicare Enrollment ID | O20210308001675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942840384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brenda L Marcum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679800395 PECOS PAC ID: 2860653292 Enrollment ID: I20120412000050 |
| Provider Name | Gina M Justice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730586470 PECOS PAC ID: 3678875044 Enrollment ID: I20160104000079 |
| Provider Name | Kimberly A Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972191195 PECOS PAC ID: 9931515178 Enrollment ID: I20210312000498 |
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