| Mark Hopperstad, BACHELORS | |
|
101 Bacon St, Pawtucket, RI 02860-5542 | |
| (401) 724-8400 | |
| (401) 722-5280 |
| Full Name | Mark Hopperstad |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 7 Years |
| Location | 101 Bacon St, Pawtucket, Rhode Island |
| 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 |
|---|---|---|---|
| 1558783373 | NPI | - | NPPES |
| GH57134 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sb Transitional Sub Llc | 7911315379 | 63 |
| Entity Name | Sb Transitional Sub Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962091173 PECOS PAC ID: 7911315379 Enrollment ID: O20210423000601 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Hopperstad, BACHELORS 101 Bacon St, Pawtucket, RI 02860-5542 Ph: (401) 724-8400 | Mark Hopperstad, BACHELORS 101 Bacon St, Pawtucket, RI 02860-5542 Ph: (401) 724-8400 |
John Walker, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 160 Beechwood Ave, Pawtucket, RI 02860 Phone: 401-722-5573 | |
Trisha Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 101 Bacon St, Pawtucket, RI 02860 Phone: 401-724-8400 Fax: 401-722-5280 | |
Mr. James Gerard Gregory, LICSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Lafayette St, Pawtucket, RI 02860 Phone: 401-771-7016 | |
Ms. Jennifer M Pelkey, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 249 Roosevelt Ave, Pawtucket, RI 02860 Phone: 401-724-8400 | |
Kelsey Francis, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 190 Cottage St Apt 1, Pawtucket, RI 02860 Phone: 603-819-9004 | |
John Echeverry, BACHELORS Counselor Medicare: Not Enrolled in Medicare Practice Location: 160 Beechwood Ave, Pawtucket, RI 02860 Phone: 401-722-5573 Fax: 401-724-9735 | |
Catherine Fogarty, Counselor Medicare: Not Enrolled in Medicare Practice Location: 31 N Union St, Pawtucket, RI 02860 Phone: 401-725-2520 |