| Ethan Bardell, | |
|
165 Main St, Ste A, Cortland, NY 13045-3049 | |
| (607) 753-0234 | |
| Not Available |
| Full Name | Ethan Bardell |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 8 Years |
| Location | 165 Main St, Cortland, New York |
| 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 |
|---|---|---|---|
| 1215583067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 101837 (New York) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mccd Psychiatry Services Pllc | 4082049036 | 203 |
| Entity Name | Mccd Psychiatry Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033750823 PECOS PAC ID: 4082049036 Enrollment ID: O20200121001374 |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan Bardell, 165 Main St, Ste A, Cortland, NY 13045-3049 Ph: (607) 753-0234 | Ethan Bardell, 165 Main St, Ste A, Cortland, NY 13045-3049 Ph: (607) 753-0234 |
Tristen E Turkow, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 165 Main St. Ste A, Cortland, NY 13045 Phone: 607-753-0234 | |
Sarah Elizabeth Loomis, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 165 Main St Ste A, Cortland, NY 13045 Phone: 607-753-0234 | |
Mrs. Kelley G Brown, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 10 N Main St, Cortland, NY 13045 Phone: 607-753-0234 Fax: 607-753-0286 | |
Jonathan D Moe, MS Counselor Medicare: Accepting Medicare Assignments Practice Location: 10 N Main St, Cortland, NY 13045 Phone: 607-753-0234 Fax: 607-753-0286 | |
Wendy Hutton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 165 Main St, Ste A, Cortland, NY 13045 Phone: 607-753-0234 | |
Doretha Michelle Baker, CASAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 165 Main St Ste A, Cortland, NY 13045 Phone: 607-753-0234 | |
Abigail A Withers, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 10 N Main St, Cortland, NY 13045 Phone: 607-753-0234 Fax: 607-753-0286 |