| Wiregrass Wellness Center, Llc | |
|
201 Regency Ct Dothan AL 36305-1179 | |
| (334) 673-8869 | |
| (334) 673-8851 |
| Full Name | Wiregrass Wellness Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 201 Regency Ct, Dothan, Alabama |
| Authorized Official Name and Position | David Kenton Strunk (CFO) |
| Authorized Official Contact | 4232150627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wiregrass Wellness Center, Llc Po Box 8308 Dothan AL 36304-0308 Ph: (334) 673-8869 | Wiregrass Wellness Center, Llc 201 Regency Ct Dothan AL 36305-1179 Ph: (334) 673-8869 |
| NPI Number | 1013117167 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 05/21/2020 |
| Medicare PECOS PAC ID | 9234106147 |
|---|---|
| Medicare Enrollment ID | O20040910001105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013117167 | NPI | - | NPPES |
| 229432 | Medicaid | AL | |
| 914438200 | Medicaid | FL | |
| 1080690 | Other | FL | BEACON |
| 11498415 | Other | CAQH | |
| 410459675 | Other | AL | TRICARE |
| 50198 | Other | FL | FLORIDA BLUE |
| 601701400 | Other | AL | DOL |
| 009966175 | Medicaid | AL | |
| 010838800 | Medicaid | FL | |
| 188102 | Medicaid | AL | |
| 774089000 | Other | AL | MAGELLAN |
| 0348462 | Other | AL | CIGNA |
| 1104332527 | Other | NPI | |
| 407098142C | Medicaid | GA | |
| 529920780 | Medicaid | AL | |
| Q6YNL | Other | FL | FLORIDA BCBS |
| 51521565 | Other | AL | BCBS |
| $$$$$$$$$ | Other | SSN | |
| 1013117167 | Other | NPI | |
| 1811983596 | Other | NPI | |
| 19C1R | Other | AL | NEW DIRECTIONS |
| 523314 | Other | AL | VALUE OPTIONS |
| Provider Name | John C Strunk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811983596 PECOS PAC ID: 7113994021 Enrollment ID: I20040915001064 |
| Provider Name | Dallarie Charme Jamison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083079453 PECOS PAC ID: 3173822335 Enrollment ID: I20160422001086 |
| Provider Name | Jimmie S Guyton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932664653 PECOS PAC ID: 3870833429 Enrollment ID: I20190319001948 |
| Provider Name | Jennifer Ethel Sizemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255965919 PECOS PAC ID: 5597189456 Enrollment ID: I20200901002992 |
| Provider Name | Tracy Marie Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104332527 PECOS PAC ID: 7517216617 Enrollment ID: I20210108001668 |
| Provider Name | Dana H Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588911168 PECOS PAC ID: 2163808692 Enrollment ID: I20221006000160 |
Sanctuary Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1450 Ross Clark Cir, Dothan, AL 36301 Phone: 334-794-2113 | |
Dothan Neurology Clinic, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4300 W Main St, Suite 102, Dothan, AL 36305 Phone: 334-793-9564 Fax: 334-671-8907 | |
Southeast Alabama Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 Ross Clark Cir, Dothan, AL 36301 Phone: 334-793-8111 Fax: 334-793-8147 | |
Life Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 S Foster St, Dothan, AL 36301 Phone: 719-684-6715 | |
Southeast Psychiatric Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2812 Hartford Hwy Ste 1, Dothan, AL 36305 Phone: 334-712-1170 Fax: 334-460-8391 | |
Dothan Neurodiagnostic Center Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Fairview Ave, Suite 1, Dothan, AL 36301 Phone: 334-793-1703 Fax: 334-793-9314 |