OrganizationHagerstown Integrative Mental HealthNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1185 Mount Aetna Rd Ste 102, Hagerstown, MD 21740-6832(865) 804-4067PECOS EnrollmentBased on the most recent information from CMS, provider Hagerstown Integrative Mental Health does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:02 AM.Profile DetailsProvider ID1861027146Provider TypeOrganizationFull NameHagerstown Integrative Mental HealthSubpartNoEnumeration Date3/7/2020Last Updated3/7/2020Contact InformationPractice LocationPractice Address1185 Mount Aetna Rd Ste 102, Hagerstown, MD 21740-6832Phone(865) 804-4067FaxUnlisted FaxMailing LocationMailing Address14315 Luella Pl, Hagerstown, MD 21740-1186PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameBennett, Christopher Gabriel (Psychiatric Nurse Practitioner)Phone(865) 804-4067Provider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer