| Centerstone Of Indiana, Inc. | |
|
645 S Rogers St Bloomington IN 47403 | |
| (812) 339-1691 | |
| (812) 337-2438 |
| Full Name | Centerstone Of Indiana, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 645 S Rogers St, Bloomington, Indiana |
| Authorized Official Name and Position | Suzanne L Koesel (CEO) |
| Authorized Official Contact | 8123372350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerstone Of Indiana, Inc. 645 S Rogers Street Bloomington IN 47403-2353 Ph: (812) 339-1691 | Centerstone Of Indiana, Inc. 645 S Rogers St Bloomington IN 47403 Ph: (812) 339-1691 |
| NPI Number | 1992781470 |
|---|---|
| Provider Enumeration Date | 12/16/2005 |
| Last Update Date | 12/17/2018 |
| Medicare PECOS PAC ID | 9436138427 |
|---|---|
| Medicare Enrollment ID | O20040830000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992781470 | NPI | - | NPPES |
| 100182650 | Medicaid | IN |
| Provider Name | Mary Jean Schwendener Holt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336176288 PECOS PAC ID: 6608856349 Enrollment ID: I20040722000887 |
| Provider Name | William C Spence |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740381748 PECOS PAC ID: 3678543675 Enrollment ID: I20040728000278 |
| Provider Name | Benjamin R Sklar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588636963 PECOS PAC ID: 6204808074 Enrollment ID: I20040811000959 |
| Provider Name | William E Cooke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699749770 PECOS PAC ID: 7719955251 Enrollment ID: I20040924000609 |
| Provider Name | Thelma L Young-bolden |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1316910367 PECOS PAC ID: 7719939438 Enrollment ID: I20050210000584 |
| Provider Name | Mark S Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033221692 PECOS PAC ID: 2668429911 Enrollment ID: I20050407001097 |
| Provider Name | Darla K Mckeeman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235101544 PECOS PAC ID: 1052359593 Enrollment ID: I20050425000486 |
| Provider Name | Nidavanh Klopfenstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275694911 PECOS PAC ID: 4082654256 Enrollment ID: I20050506000230 |
| Provider Name | Ron Masters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932223096 PECOS PAC ID: 0547205585 Enrollment ID: I20050621000834 |
| Provider Name | Jerry E Neff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922083567 PECOS PAC ID: 9133161029 Enrollment ID: I20050708000327 |
| Provider Name | Jonikka E Vance |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043303514 PECOS PAC ID: 4486681822 Enrollment ID: I20050718000824 |
| Provider Name | Anne Mary Leach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780661918 PECOS PAC ID: 0547284085 Enrollment ID: I20060123000902 |
| Provider Name | Stephanie L Estell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134192271 PECOS PAC ID: 3072529957 Enrollment ID: I20060301000750 |
| Provider Name | Gregory S Sidell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780603530 PECOS PAC ID: 5395754469 Enrollment ID: I20060418000472 |
| Provider Name | Linda Ellen Hisle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164433488 PECOS PAC ID: 3072617182 Enrollment ID: I20070329000549 |
| Provider Name | Lisa M Brownlee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699865824 PECOS PAC ID: 7113024514 Enrollment ID: I20070519000003 |
| Provider Name | Susan K Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619041191 PECOS PAC ID: 2264539667 Enrollment ID: I20070519000033 |
| Provider Name | Kevin M Terrell |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1760591648 PECOS PAC ID: 3779674429 Enrollment ID: I20070809000282 |
| Provider Name | Katherine M Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659315315 PECOS PAC ID: 4789775149 Enrollment ID: I20070814000653 |
| Provider Name | Lia R Kettenis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346459146 PECOS PAC ID: 7416041629 Enrollment ID: I20070919000477 |
| Provider Name | Megan L White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003039553 PECOS PAC ID: 9133298425 Enrollment ID: I20080513000000 |
| Provider Name | Bethany A Murray |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1023094174 PECOS PAC ID: 1052480381 Enrollment ID: I20080513000389 |
| Provider Name | Susan C Kell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1477521045 PECOS PAC ID: 7113090101 Enrollment ID: I20080724000267 |
| Provider Name | Kenneth F Conway |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154393585 PECOS PAC ID: 9537236138 Enrollment ID: I20090206000080 |
| Provider Name | Vinita S Watts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760454839 PECOS PAC ID: 1759446677 Enrollment ID: I20090210000178 |
| Provider Name | Elaine C Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366429508 PECOS PAC ID: 7012072788 Enrollment ID: I20090212000148 |
| Provider Name | Michael E Welling |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821060294 PECOS PAC ID: 9133284664 Enrollment ID: I20090218000054 |
| Provider Name | Susan W Schneider |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508838657 PECOS PAC ID: 9234185620 Enrollment ID: I20090218000123 |
| Provider Name | Renee E Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346494572 PECOS PAC ID: 3870659477 Enrollment ID: I20090306000049 |
| Provider Name | Jane E Scruton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760454169 PECOS PAC ID: 5890851174 Enrollment ID: I20090312000065 |
| Provider Name | Betty J Barr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275505323 PECOS PAC ID: 7719034958 Enrollment ID: I20090406000198 |
| Provider Name | Joy L Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487788964 PECOS PAC ID: 7911054432 Enrollment ID: I20090420000415 |
| Provider Name | Glen K Stephenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205808227 PECOS PAC ID: 2567519036 Enrollment ID: I20090421000139 |
| Provider Name | Gregory V Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215095773 PECOS PAC ID: 9032269295 Enrollment ID: I20090609000457 |
| Provider Name | Joy L Stagg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356304570 PECOS PAC ID: 7911053939 Enrollment ID: I20090916000517 |
| Provider Name | Camila L Arnaudo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770669137 PECOS PAC ID: 5698821999 Enrollment ID: I20090928000362 |
| Provider Name | Debra A Marshino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629049044 PECOS PAC ID: 0941346100 Enrollment ID: I20091001000703 |
| Provider Name | Joan B Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114999372 PECOS PAC ID: 2668518648 Enrollment ID: I20091005000622 |
| Provider Name | William V Roll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427067297 PECOS PAC ID: 0345380770 Enrollment ID: I20091216000333 |
| Provider Name | Rhonda S Friend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427128149 PECOS PAC ID: 5294875530 Enrollment ID: I20091218000007 |
| Provider Name | Sheila R Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891706941 PECOS PAC ID: 4789724923 Enrollment ID: I20091218000058 |
| Provider Name | Scott Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093734626 PECOS PAC ID: 1052444353 Enrollment ID: I20100807000001 |
| Provider Name | Janet D Gray |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1497765218 PECOS PAC ID: 0648310839 Enrollment ID: I20100810000375 |
| Provider Name | Ursula S Mccormick |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1689658874 PECOS PAC ID: 0345366068 Enrollment ID: I20100929001655 |
| Provider Name | James G Marencik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043295694 PECOS PAC ID: 9931393519 Enrollment ID: I20101027001018 |
| Provider Name | Joel H Griffith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194747618 PECOS PAC ID: 5890976096 Enrollment ID: I20110222000167 |
| Provider Name | Katera A Huff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306091848 PECOS PAC ID: 1951579903 Enrollment ID: I20110719000579 |
| Provider Name | Fiora G Pizzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053699058 PECOS PAC ID: 0446420491 Enrollment ID: I20110830000257 |
| Provider Name | Jessica R Hamlyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205906922 PECOS PAC ID: 8729254545 Enrollment ID: I20111229000032 |
| Provider Name | Megan B Hawk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265512495 PECOS PAC ID: 8921266255 Enrollment ID: I20120216000082 |
| Provider Name | Amanda R Mckinley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669667481 PECOS PAC ID: 6204099260 Enrollment ID: I20120531000570 |
| Provider Name | Karen L Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174548812 PECOS PAC ID: 9537323605 Enrollment ID: I20120621000400 |
| Provider Name | Sheila Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659629665 PECOS PAC ID: 9739338179 Enrollment ID: I20120928000706 |
| Provider Name | Della J Busby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215039144 PECOS PAC ID: 0446211726 Enrollment ID: I20130114000416 |
| Provider Name | Bridget V Rund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528376779 PECOS PAC ID: 2860647021 Enrollment ID: I20130220000045 |
| Provider Name | Paul S Taraska |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912137290 PECOS PAC ID: 3971744814 Enrollment ID: I20130718000764 |
| Provider Name | Ross Manning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871835769 PECOS PAC ID: 6608010020 Enrollment ID: I20130924000800 |
| Provider Name | Jennifer Lee Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568768018 PECOS PAC ID: 1052546405 Enrollment ID: I20131021001419 |
| Provider Name | Gene A Baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972871440 PECOS PAC ID: 3375772791 Enrollment ID: I20140206000378 |
| Provider Name | Brittany D Mcnew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750714366 PECOS PAC ID: 9335379437 Enrollment ID: I20140312000801 |
| Provider Name | Michael L Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154393031 PECOS PAC ID: 0446482236 Enrollment ID: I20140409001596 |
| Provider Name | Jennifer Hutchens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508285727 PECOS PAC ID: 5395978043 Enrollment ID: I20140502001082 |
| Provider Name | Patricia M Rubino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265688055 PECOS PAC ID: 4981843679 Enrollment ID: I20140513002121 |
| Provider Name | Cynthia F Port |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407115793 PECOS PAC ID: 8426276981 Enrollment ID: I20140825001123 |
| Provider Name | Kelle M Zeabart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902229222 PECOS PAC ID: 9931329455 Enrollment ID: I20141006001269 |
| Provider Name | Melissa Katherine Hatton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073920567 PECOS PAC ID: 4082835715 Enrollment ID: I20141022002199 |
| Provider Name | Dallas A Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184024515 PECOS PAC ID: 7315169026 Enrollment ID: I20141113001110 |
| Provider Name | Nannie Abner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558540997 PECOS PAC ID: 6608019526 Enrollment ID: I20141208001634 |
| Provider Name | Nishanie Gunawardane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235440082 PECOS PAC ID: 4486969003 Enrollment ID: I20150811005724 |
| Provider Name | Marina Bota |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164430831 PECOS PAC ID: 8325083801 Enrollment ID: I20150812006873 |
| Provider Name | Angela R Witzmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215971833 PECOS PAC ID: 1254578115 Enrollment ID: I20151229002664 |
| Provider Name | Pamela S Barron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053570960 PECOS PAC ID: 2163678665 Enrollment ID: I20160114000935 |
| Provider Name | Ellen Kazlas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992024616 PECOS PAC ID: 6608171319 Enrollment ID: I20160217002167 |
| Provider Name | Leslie A Wilfong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164880852 PECOS PAC ID: 6305142704 Enrollment ID: I20160310002254 |
| Provider Name | Ashley M Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841573359 PECOS PAC ID: 4183923535 Enrollment ID: I20160505002367 |
| Provider Name | Carolyn Britt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053389197 PECOS PAC ID: 3779878970 Enrollment ID: I20160826002197 |
| Provider Name | Danielle A Fluhr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689998023 PECOS PAC ID: 9335435908 Enrollment ID: I20160907002495 |
| Provider Name | Robert B Watts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811440175 PECOS PAC ID: 6608162227 Enrollment ID: I20160908001196 |
| Provider Name | Lauren C Lutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417407743 PECOS PAC ID: 2668752437 Enrollment ID: I20161213002279 |
| Provider Name | Ashley A Gauck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225476583 PECOS PAC ID: 2264714971 Enrollment ID: I20170112001771 |
| Provider Name | Lindsay M Potts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326584772 PECOS PAC ID: 4688956402 Enrollment ID: I20170131000494 |
| Provider Name | Amanda J Lear |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962940650 PECOS PAC ID: 7113202789 Enrollment ID: I20170322000452 |
| Provider Name | Amanda R Mullins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093885733 PECOS PAC ID: 6608144068 Enrollment ID: I20170608001054 |
| Provider Name | Courtney Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801319231 PECOS PAC ID: 2264705029 Enrollment ID: I20170830002751 |
| Provider Name | Richard Saini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871532168 PECOS PAC ID: 1153696190 Enrollment ID: I20171002001946 |
| Provider Name | Deanna Gamroth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710403530 PECOS PAC ID: 8325313372 Enrollment ID: I20171002002022 |
| Provider Name | Rebecca E Lovejoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730596438 PECOS PAC ID: 2062788300 Enrollment ID: I20171101000254 |
| Provider Name | Brianna D Underhill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346751328 PECOS PAC ID: 9234405572 Enrollment ID: I20171101000273 |
| Provider Name | Colleen M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215474929 PECOS PAC ID: 7911280839 Enrollment ID: I20171114000115 |
| Provider Name | Marcia L Cantrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164530648 PECOS PAC ID: 5092073304 Enrollment ID: I20171214001145 |
| Provider Name | Peter Davies |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225484447 PECOS PAC ID: 6406114750 Enrollment ID: I20171214002919 |
| Provider Name | Christopher D Crist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417463191 PECOS PAC ID: 2163782350 Enrollment ID: I20180208000792 |
| Provider Name | Cheryl L Turner-romans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669960845 PECOS PAC ID: 4486919362 Enrollment ID: I20180523002926 |
| Provider Name | Archana Barry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609878545 PECOS PAC ID: 3173411337 Enrollment ID: I20180628001231 |
| Provider Name | Sarah Donaldson-vargha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780091512 PECOS PAC ID: 1759501109 Enrollment ID: I20180824001323 |
| Provider Name | Mary L Pruett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053385187 PECOS PAC ID: 1254681778 Enrollment ID: I20180904003565 |
| Provider Name | Sherida J Newmister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972623023 PECOS PAC ID: 7113277641 Enrollment ID: I20180905000210 |
| Provider Name | Daniel A Pietras |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912346123 PECOS PAC ID: 1153548938 Enrollment ID: I20180928000022 |
| Provider Name | Morgan B Reeve |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891240081 PECOS PAC ID: 6002160702 Enrollment ID: I20181115002396 |
| Provider Name | Ruth L Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659845139 PECOS PAC ID: 4880933027 Enrollment ID: I20190305002116 |
| Provider Name | Brandy R Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871153916 PECOS PAC ID: 9032445572 Enrollment ID: I20190722003148 |
| Provider Name | Jillian L Tebbe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902183718 PECOS PAC ID: 7416285093 Enrollment ID: I20190820003332 |
| Provider Name | Shauna L Kuhbander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427529148 PECOS PAC ID: 4082953526 Enrollment ID: I20190909002773 |
| Provider Name | Rebecca M Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659896306 PECOS PAC ID: 2769819234 Enrollment ID: I20200221001328 |
| Provider Name | Shayne Rhoads |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700315561 PECOS PAC ID: 3779910096 Enrollment ID: I20200227000065 |
| Provider Name | Bethany Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336591668 PECOS PAC ID: 5991133373 Enrollment ID: I20200318000820 |
| Provider Name | Kirsten Heitkamp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356985162 PECOS PAC ID: 3577991728 Enrollment ID: I20200322000008 |
| Provider Name | Kourtney Marie Gallegos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831644319 PECOS PAC ID: 6800224809 Enrollment ID: I20200324003231 |
| Provider Name | Karen R Seng |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255382974 PECOS PAC ID: 2567891286 Enrollment ID: I20200401001093 |
| Provider Name | Kimberly Beverly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740835164 PECOS PAC ID: 0941626964 Enrollment ID: I20200820001324 |
| Provider Name | Kassie Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972114924 PECOS PAC ID: 5890112163 Enrollment ID: I20200901001823 |
| Provider Name | Kimberley Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720129117 PECOS PAC ID: 3870927072 Enrollment ID: I20200921002912 |
| Provider Name | Whitney Lea Marocco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265059752 PECOS PAC ID: 4981023272 Enrollment ID: I20201006003073 |
| Provider Name | Melissa Sarnecki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639770209 PECOS PAC ID: 6507276979 Enrollment ID: I20201113001999 |
| Provider Name | Kristen Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609471051 PECOS PAC ID: 2567874761 Enrollment ID: I20201211001579 |
| Provider Name | Alicia Aldridge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164873881 PECOS PAC ID: 4587076781 Enrollment ID: I20201211001974 |
| Provider Name | Amy Belcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972194744 PECOS PAC ID: 2466867163 Enrollment ID: I20210210000959 |
| Provider Name | Amber Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700478930 PECOS PAC ID: 5294140620 Enrollment ID: I20210217002742 |
| Provider Name | Lucas Krickenbarger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407440076 PECOS PAC ID: 3274949185 Enrollment ID: I20210301001324 |
| Provider Name | Amy Elliott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407109671 PECOS PAC ID: 9931518834 Enrollment ID: I20210505001739 |
| Provider Name | Ashley E Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609459791 PECOS PAC ID: 7810306669 Enrollment ID: I20210506001678 |
| Provider Name | Lisa Whittaker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336717792 PECOS PAC ID: 0446651020 Enrollment ID: I20210702002095 |
| Provider Name | Kendall Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851963086 PECOS PAC ID: 7618370982 Enrollment ID: I20210723001438 |
| Provider Name | Kelley Ellen Stafford Salvo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780266106 PECOS PAC ID: 9931503695 Enrollment ID: I20210803003060 |
| Provider Name | Hannah Small |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881367282 PECOS PAC ID: 1153725395 Enrollment ID: I20210810001258 |
| Provider Name | Misti Paynter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699348128 PECOS PAC ID: 5294139432 Enrollment ID: I20210810001492 |
| Provider Name | Heather Marie Blue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306427331 PECOS PAC ID: 3971907908 Enrollment ID: I20210812001024 |
| Provider Name | Carol Korb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609542075 PECOS PAC ID: 0143625335 Enrollment ID: I20210826001060 |
| Provider Name | Jessica Rabiola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245909605 PECOS PAC ID: 6800293846 Enrollment ID: I20210917002756 |
| Provider Name | Meagan Barnhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821767294 PECOS PAC ID: 1658778527 Enrollment ID: I20210920001286 |
| Provider Name | Kelly Saltzgaber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093486813 PECOS PAC ID: 7719384247 Enrollment ID: I20210924002038 |
| Provider Name | Karen Poling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588335699 PECOS PAC ID: 4082011358 Enrollment ID: I20210929001912 |
| Provider Name | Deonya Muhammad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487848230 PECOS PAC ID: 7719293737 Enrollment ID: I20211104002035 |
| Provider Name | Shantel Ball |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619632163 PECOS PAC ID: 0345639290 Enrollment ID: I20211115000886 |
| Provider Name | Tiffany Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154720597 PECOS PAC ID: 8921497850 Enrollment ID: I20211116001028 |
| Provider Name | Nikkia O'bannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386302321 PECOS PAC ID: 4789075367 Enrollment ID: I20211216000589 |
| Provider Name | Sara Garrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891449773 PECOS PAC ID: 6204229388 Enrollment ID: I20220214001112 |
| Provider Name | Samantha Richards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023765799 PECOS PAC ID: 7416342423 Enrollment ID: I20220309001846 |
| Provider Name | James Thomas Fries |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861141806 PECOS PAC ID: 9234524448 Enrollment ID: I20220324000782 |
| Provider Name | Kristyne Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063885333 PECOS PAC ID: 8325428295 Enrollment ID: I20220708003424 |
| Provider Name | Mackenzie Prendergast |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952020158 PECOS PAC ID: 9830573286 Enrollment ID: I20220902000344 |
| Provider Name | Tracy Weinke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649908427 PECOS PAC ID: 9133503303 Enrollment ID: I20220907002593 |
| Provider Name | Alison Claire Sander |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104264126 PECOS PAC ID: 9133505563 Enrollment ID: I20221007001381 |
| Provider Name | Sarah Basmadji |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891467338 PECOS PAC ID: 7517333693 Enrollment ID: I20221013003117 |
| Provider Name | Jennifer Bottomley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871203943 PECOS PAC ID: 5395114821 Enrollment ID: I20221206000427 |
| Provider Name | Morgan Flora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386358281 PECOS PAC ID: 4587035282 Enrollment ID: I20230117000766 |
| Provider Name | Emily Brault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740987411 PECOS PAC ID: 8729451414 Enrollment ID: I20230228000832 |
| Provider Name | Melissa Kay Oran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639878275 PECOS PAC ID: 4789058363 Enrollment ID: I20230322000974 |
| Provider Name | Julia O'donnell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659074284 PECOS PAC ID: 6002280344 Enrollment ID: I20230328000916 |
| Provider Name | Jeannette Marie Lachappelle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386307445 PECOS PAC ID: 2466817382 Enrollment ID: I20230428001115 |
| Provider Name | Kadie Booth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225723059 PECOS PAC ID: 7618332180 Enrollment ID: I20230505001453 |
| Provider Name | Brian Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407545551 PECOS PAC ID: 0547626947 Enrollment ID: I20230509001870 |
| Provider Name | Jayme Battaglia-jennings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053007260 PECOS PAC ID: 8325404676 Enrollment ID: I20230511003190 |
| Provider Name | Patricia Yaryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023796596 PECOS PAC ID: 9830559566 Enrollment ID: I20230713000968 |
| Provider Name | Melissa Kilpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518646751 PECOS PAC ID: 9931560125 Enrollment ID: I20230803004093 |
| Provider Name | Katherine Brumfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437935814 PECOS PAC ID: 5294199238 Enrollment ID: I20230911000775 |
| Provider Name | Michael Marino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841071800 PECOS PAC ID: 3375998164 Enrollment ID: I20231013003060 |
| Provider Name | Cheryl Berger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548490279 PECOS PAC ID: 9739539503 Enrollment ID: I20231220002859 |
| Provider Name | Don L Degner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881784080 PECOS PAC ID: 5698125359 Enrollment ID: I20231221002390 |
| Provider Name | Michelle Adams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518747344 PECOS PAC ID: 7012367774 Enrollment ID: I20231221002521 |
| Provider Name | Daniel Cervantes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033626601 PECOS PAC ID: 5698125250 Enrollment ID: I20231221002802 |
| Provider Name | Shawn Michael Arroyo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255786885 PECOS PAC ID: 1658721220 Enrollment ID: I20231221003431 |
| Provider Name | Alexandria Smart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629651294 PECOS PAC ID: 8123478732 Enrollment ID: I20231222000542 |
| Provider Name | Terry Mayo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518627637 PECOS PAC ID: 0446600050 Enrollment ID: I20231222000738 |
| Provider Name | Gina Lynn Vivaldi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699321679 PECOS PAC ID: 8426408030 Enrollment ID: I20231222000829 |
| Provider Name | Kristy Macku |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225252638 PECOS PAC ID: 5597115113 Enrollment ID: I20231222001016 |
| Provider Name | Valerie Darling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073252102 PECOS PAC ID: 8123479409 Enrollment ID: I20240111000620 |
| Provider Name | Madeline Sheets |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669158465 PECOS PAC ID: 1254782535 Enrollment ID: I20240111000861 |
| Provider Name | Anne Weisbach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033844691 PECOS PAC ID: 7012368301 Enrollment ID: I20240111001112 |
| Provider Name | Brittany Drawbaugh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548828551 PECOS PAC ID: 7517318801 Enrollment ID: I20240111001290 |
| Provider Name | Kami Grimes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215905187 PECOS PAC ID: 4587015888 Enrollment ID: I20240111001497 |
| Provider Name | Sarah Ann Harvey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134753957 PECOS PAC ID: 8123470960 Enrollment ID: I20240117003939 |
| Provider Name | Sharon V Foley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285970095 PECOS PAC ID: 2062864648 Enrollment ID: I20240118004472 |
| Provider Name | Mary Patia Rae Tabar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275053746 PECOS PAC ID: 1658723259 Enrollment ID: I20240119000255 |
| Provider Name | Jason Woods |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538644083 PECOS PAC ID: 7416309018 Enrollment ID: I20240119000449 |
| Provider Name | Sherri Marcum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851162762 PECOS PAC ID: 4183076714 Enrollment ID: I20240119001441 |
| Provider Name | Sawyer Toll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710693296 PECOS PAC ID: 8022460567 Enrollment ID: I20240119002050 |
| Provider Name | Juli Rains |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942692835 PECOS PAC ID: 3375995780 Enrollment ID: I20240122003665 |
| Provider Name | Jessica Foster |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1518571132 PECOS PAC ID: 5698127934 Enrollment ID: I20240123000359 |
| Provider Name | Janet Kivett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609313956 PECOS PAC ID: 0446602734 Enrollment ID: I20240123001928 |
| Provider Name | Martha B. Bowman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912075045 PECOS PAC ID: 5193177392 Enrollment ID: I20240123002607 |
| Provider Name | Cathy Gregory |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437546884 PECOS PAC ID: 9931552189 Enrollment ID: I20240124002775 |
| Provider Name | Jerry Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457323560 PECOS PAC ID: 0345693461 Enrollment ID: I20240125000603 |
| Provider Name | Abbi Powell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083798011 PECOS PAC ID: 3375996135 Enrollment ID: I20240129000349 |
| Provider Name | Aris Beldavs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316516503 PECOS PAC ID: 7517310345 Enrollment ID: I20240129002477 |
| Provider Name | Laura Elizabeth Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750934238 PECOS PAC ID: 8426401266 Enrollment ID: I20240129002905 |
| Provider Name | Sheila Zeng |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003501248 PECOS PAC ID: 9436502176 Enrollment ID: I20240129003292 |
| Provider Name | Rebecca S Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972953388 PECOS PAC ID: 3971956517 Enrollment ID: I20240130002506 |
| Provider Name | Amanda Corder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790855344 PECOS PAC ID: 4284087677 Enrollment ID: I20240201002857 |
| Provider Name | Lori Scrivnor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558905372 PECOS PAC ID: 4688027089 Enrollment ID: I20240201003067 |
| Provider Name | Bonnie L Morgan-dugan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174089619 PECOS PAC ID: 9032552377 Enrollment ID: I20240203000154 |
| Provider Name | Jessica Grace Sanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831494533 PECOS PAC ID: 6002290582 Enrollment ID: I20240210000127 |
| Provider Name | Kati Guernsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144792888 PECOS PAC ID: 6709229149 Enrollment ID: I20240213001617 |
| Provider Name | Teresa Mcdaniel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972692390 PECOS PAC ID: 8426492745 Enrollment ID: I20240214003626 |
| Provider Name | Macy Kootz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508620964 PECOS PAC ID: 4385088475 Enrollment ID: I20240216001074 |
| Provider Name | Kelly S Benedict |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376632109 PECOS PAC ID: 7618311135 Enrollment ID: I20240222003226 |
| Provider Name | Tracey M Lickfelt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770672206 PECOS PAC ID: 6204271471 Enrollment ID: I20240227003207 |
| Provider Name | Heather R Buckland |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003091133 PECOS PAC ID: 0244675320 Enrollment ID: I20240228002647 |
| Provider Name | Sarah Knoy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164288510 PECOS PAC ID: 5294170825 Enrollment ID: I20240305001526 |
| Provider Name | Lisa Simpson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396113916 PECOS PAC ID: 5395181945 Enrollment ID: I20240306001689 |
| Provider Name | Amber Millay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780142117 PECOS PAC ID: 2163868241 Enrollment ID: I20240312000562 |
| Provider Name | Kimberly Dawn Justus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710206446 PECOS PAC ID: 1658717699 Enrollment ID: I20240312003496 |
| Provider Name | Samantha Girot |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043820608 PECOS PAC ID: 4082050729 Enrollment ID: I20240315002364 |
Diane Menke Pence, Lmhc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 N College Ave, Ste 613, Bloomington, IN 47404 Phone: 812-333-3440 Fax: 812-333-3444 | |
Huts Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2801 E Plateau Place, Bloomington, IN 47401 Phone: 804-386-9216 Fax: 804-464-1483 | |
Bloomington Meadows Physicians Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3600 N Prow Rd, Bloomington, IN 47404 Phone: 812-331-8000 Fax: 812-331-8985 | |
Angela R Marshall Psyd Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2525 W Vernal Pike, Bloomington, IN 47404 Phone: 812-345-5114 Fax: 812-339-0369 | |
New Outlook Counseling Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5010 N Stone Mill Rd, Suite B, Bloomington, IN 47408 Phone: 812-929-2193 Fax: 888-789-8394 | |
Leah Sinn Iversen Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 518 N Colony Ct, Bloomington, IN 47408 Phone: 812-320-2017 | |
Brad Stepp, Psyd Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 E John Hinkle Pl Ste 104, Bloomington, IN 47408 Phone: 812-329-5277 |