Community Care Of Bridgeport - Medicare Mental Health Clinic in Bridgeport, WV

Community Care Of Bridgeport is a medicare enrolled mental health clinic (Community/behavioral Health) in Bridgeport, West Virginia. The current practice location for Community Care Of Bridgeport is 65 Professional Pl Ste 101, Bridgeport, West Virginia. For appointments, you can reach them via phone at (304) 848-5770. The mailing address for Community Care Of Bridgeport is 65 Professional Pl Ste 101, Bridgeport, West Virginia and phone number is (304) 848-5770.

Community Care Of Bridgeport is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1144811290. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (304) 848-5770.

Contact Information

Community Care Of Bridgeport
65 Professional Pl Ste 101
Bridgeport
WV 26330-1889
(304) 848-5770
(304) 848-0890

Mental Health Clinic Profile

Full NameCommunity Care Of Bridgeport
SpecialityCommunity/Behavioral Health
Location65 Professional Pl Ste 101, Bridgeport, West Virginia
Authorized Official Name and PositionDora L Potasnik (CREDENTIALING COORDINATOR)
Authorized Official Contact3043177275
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Community Care Of Bridgeport
65 Professional Pl Ste 101
Bridgeport
WV 26330-1889

Ph: (304) 848-5770
Community Care Of Bridgeport
65 Professional Pl Ste 101
Bridgeport
WV 26330-1889

Ph: (304) 848-5770

NPI Details:

NPI Number1144811290
Provider Enumeration Date02/01/2021
Last Update Date02/17/2021
Certification Date02/02/2021

Medicare PECOS Information:

Medicare PECOS PAC ID0446232987
Medicare Enrollment IDO20210331002097

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Medical Identifiers

Medical identifiers for Community Care Of Bridgeport such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144811290NPI-NPPES
516OtherWVSTATE OF WV DEPARTMENT OF HEALTH AND HUMAN SERVICES BEHAVIORAL HEALTH LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
251S00000XCommunity/behavioral Health (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Community Care Of Bridgeport acts as a billing entity for following providers:
Provider NameHeather A Radcliffe
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1649539396
PECOS PAC ID: 1951557115
Enrollment ID: I20120803000706

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Provider NameJoan M Doris
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1396149266
PECOS PAC ID: 7113241423
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Provider NameLiam Patrick Condon
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1770080186
PECOS PAC ID: 8527323518
Enrollment ID: I20180522000973

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Provider NameBenjamin Douglas Hines
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1144664863
PECOS PAC ID: 2860795242
Enrollment ID: I20180817002125

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Provider NameAlyssa Vougas
Provider TypePractitioner - Clinical Social Worker
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PECOS PAC ID: 2567364995
Enrollment ID: I20210329000387

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Community/Behavioral Health in Bridgeport, WV

Healing Minds Clinic, Pllc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 65 Professional Place, Suite 101, Bridgeport, WV 26330
Phone: 304-842-6463    Fax: 304-842-8180
Aaron Medina Counseling, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 113 State St, Bridgeport, WV 26330
Phone: 304-842-3404    
Hamner Psychological Services
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 917 W Main St, Harron Square, Suite 203, Bridgeport, WV 26330
Phone: 304-842-7007    Fax: 304-842-7099
Hinkle Counseling & Psychological Center, Pllc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 147 E Main St, Bridgeport, WV 26330
Phone: 304-848-0660    
Sound Mind Therapeutic Center, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 41 Devonwood Dr Apt 101, Bridgeport, WV 26330
Phone: 304-641-3891    
Levin & Associates
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 170 Thompson Dr, Suite 103, Bridgeport, WV 26330
Phone: 304-842-6609    Fax: 304-842-6619

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