| Andrew Portlock, | |
|
8555 Taft St, Merrillville, IN 46410-6123 | |
| (219) 769-4005 | |
| Not Available |
| Full Name | Andrew Portlock |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 10 Years |
| Location | 8555 Taft St, Merrillville, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356913578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southlake Community Mental Health Center Inc | 5991600355 | 37 |
| Entity Name | Southlake Community Mental Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821081290 PECOS PAC ID: 5991600355 Enrollment ID: O20031231000117 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Portlock, 8555 Taft St, Merrillville, IN 46410-6123 Ph: () - | Andrew Portlock, 8555 Taft St, Merrillville, IN 46410-6123 Ph: (219) 769-4005 |
Joan Palmquist Wolford, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 290 A East 90th Drive, Merrillville, IN 46410 Phone: 219-736-9115 Fax: 219-736-9131 | |
Ms. Ellen Minter, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 7108 Broadway Apt 1a, Merrillville, IN 46410 Phone: 219-810-5372 | |
Lashayia Holman, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 780 W 79th Ave, Merrillville, IN 46410 Phone: 219-214-6889 | |
Winnie H Mycka, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 8555 Taft St, Merrillville, IN 46410 Phone: 219-769-4005 | |
Laconyea Dylana Pitts-thomas, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 322 W 55th Ave, Merrillville, IN 46410 Phone: 219-985-8695 | |
Brian Pruim, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 24 Deerpath Rd, Merrillville, IN 46410 Phone: 219-213-1117 | |
Jennifer L Vickers, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8300 Broadway, Suite F1, Merrillville, IN 46410 Phone: 219-736-1000 Fax: 219-736-9699 |