MR. BRANDON W HETRICK (NPI# 1861708331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861708331 |
| Entity Type | Individual |
| Full Name | MR. BRANDON W HETRICK |
| Practice Address |
71 N Main St Washington PA 15301-4519 |
| Mailing Address |
1070 Old National Pike Fredericktown PA 15333-2114 |
| Practice Telephone | 7242284218 |
| Mailing Telephone | 7246326801 |
| Mailing Fax Number | 7246326312 |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2010-08-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | PA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | VALUE BEHAVIORAL HEALTH | 251008110 | 01 |
| PA | 1007288440089 | 05 |
| Street Address |
71 N MAIN ST |
| City | WASHINGTON |
| State | PA |
| Zip Code | 15301-4519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861474579 | Marsha L Anderson | Counselor | 71 N Main St, Suite B, Washington, PA 15301-4519 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629601208 | Tammi Kathleen Hanak | Speech-Language Pathologist | 2212 Shawnee Drive, Address Line 2, Washington, PA 15301 | 2020-02-21 |
| 1922652460 | Shannon Rouse | Nurse Practitioner | 95 Leonard Avenue Building 2 2nd Floor, Washington, PA 15301 | 2019-08-01 |
| 1700352291 | Heather Mcvay PC | Clinic/Center | 2112 North Franklin Dr, Suite 3, Washington, PA 15301 | 2018-10-23 |
| 1689169880 | Oper King | Counselor | 8 Oliver Rd, Oliver Square Suite 116, Uniontown, PA 15301 | 2018-06-29 |
| 1609374701 | Centerville Clinics Inc | Social Worker | 201 Allison Ave, Washington High School, Washington, PA 15301 | 2018-01-24 |
| 1902304009 | Centerville Clinics, Inc. | Social Worker | 50 Scenic Drive, Trinity Middle School, Washington, PA 15301 | 2018-01-24 |
| 1780182873 | Centerville Clinics, Inc | Social Worker | 252 Cameron Road, Trinity East Elementary School, Washington, PA 15301 | 2018-01-24 |
| 1700384807 | Centerville Clinics Inc | Social Worker | 801 East Wheeling St., Washington Park Elementary, Washington, PA 15301 | 2018-01-24 |
| 1992203095 | Centerville Clinics Inc | Social Worker | 2500 South Main St Ext., Trinity South Elementary School, Washington, PA 15301 | 2018-01-24 |
| 1578061784 | Centerville Clinics, Inc. | Social Worker | 225 Midland Drive, Trinity North Elelmentary School, Washington, PA 15301 | 2018-01-23 |
| Find all providers in zip 15301 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648134 | Kalila Rebecca Moore | Case Manager/Care Coordinator | 645 Pennsylvania Ave Se Ste 102, Washington, DC 20003-4379 | 2020-04-20 |
| 1144849597 | Barbara Denise Gaskins | Case Manager/Care Coordinator | 719 W 15th St Ste 727, Washington, NC 27889-3667 | 2020-04-15 |
| 1285136002 | Irene Jackson-brown | Case Manager/Care Coordinator | 5248 Colorado Ave Nw, Washington, DC 20011-3621 | 2018-03-07 |
| 1902331838 | Phillis Terry | Case Manager/Care Coordinator | 2827 7th St Ne, Washington, DC 20017-1309 | 2017-04-28 |
| 1043745953 | Devenette Satterwhite | Case Manager/Care Coordinator | 1106 45th Pl Se, Washington, DC 20019-4907 | 2017-04-28 |
| 1689106312 | Freddie Hall | Case Manager/Care Coordinator | 3501 Jay St Ne Apt 101, Washington, DC 20019-1635 | 2017-03-31 |
| 1891236071 | Ladawn Patterson | Case Manager/Care Coordinator | 5182 Eastern Ave Ne Apt 104, Washington, DC 20011-2768 | 2017-03-20 |
| 1083155618 | Kazra White | Case Manager/Care Coordinator | 600 Kenilworth Ter Ne Apt 416, Washington, DC 20019-1899 | 2017-03-15 |
| 1598206468 | Bitanya Weldesembet | Case Manager/Care Coordinator | 5930 14th St Nw Apt 301, Washington, DC 20011-1774 | 2017-03-13 |
| 1467993550 | Roberta Campbell | Case Manager/Care Coordinator | 4832 Bass Pl Se, Washington, DC 20019-5147 | 2017-03-09 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 15301 |
Please comment or provide details below to improve the information on MR. BRANDON W HETRICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.