| Lifestance Health | |
|
871 Lowcountry Blvd Ste 200 Mount Pleasant SC 29464 | |
| (843) 501-1099 | |
| Not Available |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Counselor |
| Location | 871 Lowcountry Blvd Ste 200, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Ryan Pardo (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 4252798500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health 871 Lowcountry Blvd Ste 200 Mount Pleasant SC 29464-3096 Ph: (843) 501-1099 | Lifestance Health 871 Lowcountry Blvd Ste 200 Mount Pleasant SC 29464 Ph: (843) 501-1099 |
| NPI Number | 1316375678 |
|---|---|
| Provider Enumeration Date | 10/24/2013 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Medicare PECOS PAC ID | 6204125107 |
|---|---|
| Medicare Enrollment ID | O20160517000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316375678 | NPI | - | NPPES |
| Provider Name | Donald S Hardin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508894056 PECOS PAC ID: 6709781438 Enrollment ID: I20031204000999 |
| Provider Name | William B Walkup |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386619948 PECOS PAC ID: 3678569365 Enrollment ID: I20040420001271 |
| Provider Name | Cassandra B Sims |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952359481 PECOS PAC ID: 9032186549 Enrollment ID: I20040914000872 |
| Provider Name | David Orvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700940814 PECOS PAC ID: 4385645563 Enrollment ID: I20070131000303 |
| Provider Name | Christopher C Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922171511 PECOS PAC ID: 4789786310 Enrollment ID: I20070228000040 |
| Provider Name | Cheryl L Suber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245451269 PECOS PAC ID: 9739288085 Enrollment ID: I20070627000200 |
| Provider Name | Ellen M Mchugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497939250 PECOS PAC ID: 8729160148 Enrollment ID: I20080313000100 |
| Provider Name | Derosset Myers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659331460 PECOS PAC ID: 5395932131 Enrollment ID: I20101207000096 |
| Provider Name | Jimmy Pacheco-perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487670238 PECOS PAC ID: 8123207727 Enrollment ID: I20110128000351 |
| Provider Name | Ingrid Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447548672 PECOS PAC ID: 8224208004 Enrollment ID: I20110906000105 |
| Provider Name | Jeanette E Spence |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1598076168 PECOS PAC ID: 5294909081 Enrollment ID: I20111111000696 |
| Provider Name | Julia J Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295974616 PECOS PAC ID: 5698934933 Enrollment ID: I20120306000928 |
| Provider Name | Laura S Anthony |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427349281 PECOS PAC ID: 1153580931 Enrollment ID: I20120314000566 |
| Provider Name | Robert C Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730274713 PECOS PAC ID: 7618123944 Enrollment ID: I20120801000966 |
| Provider Name | Wendy Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578603338 PECOS PAC ID: 0345489068 Enrollment ID: I20130610000407 |
| Provider Name | Markley N Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538357140 PECOS PAC ID: 1951544683 Enrollment ID: I20130828000833 |
| Provider Name | Felicia Minniette Heyward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619307956 PECOS PAC ID: 0547490237 Enrollment ID: I20140225000488 |
| Provider Name | Joseph M Ritchey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598178402 PECOS PAC ID: 8022235589 Enrollment ID: I20140807001237 |
| Provider Name | Sandra G Mccloy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659774636 PECOS PAC ID: 0840512034 Enrollment ID: I20141125000152 |
| Provider Name | Erin G Puro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518255397 PECOS PAC ID: 1557686904 Enrollment ID: I20150206001398 |
| Provider Name | Angela D Olsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881982544 PECOS PAC ID: 3577664853 Enrollment ID: I20150709000018 |
| Provider Name | Angie L Overton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346611720 PECOS PAC ID: 5799086328 Enrollment ID: I20151223001292 |
| Provider Name | Martha G Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790822450 PECOS PAC ID: 4880587328 Enrollment ID: I20160225001846 |
| Provider Name | Sarah Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164866349 PECOS PAC ID: 9830482116 Enrollment ID: I20160725000720 |
| Provider Name | Brandi J Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215480397 PECOS PAC ID: 7416244108 Enrollment ID: I20160923000616 |
| Provider Name | Carol Ann Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295952232 PECOS PAC ID: 8426207895 Enrollment ID: I20161219000421 |
| Provider Name | Dana M Szeles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922536598 PECOS PAC ID: 0547532467 Enrollment ID: I20170828000071 |
| Provider Name | Judy Figueroa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669657987 PECOS PAC ID: 8921180217 Enrollment ID: I20170926002594 |
| Provider Name | Christina Ward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992223903 PECOS PAC ID: 3678831369 Enrollment ID: I20180102000703 |
| Provider Name | Caitlin Briggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679088942 PECOS PAC ID: 1355603093 Enrollment ID: I20180319000010 |
| Provider Name | Moshe Mark Douglas Wexler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801858865 PECOS PAC ID: 2062794373 Enrollment ID: I20180320000000 |
| Provider Name | Patricia T Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578062584 PECOS PAC ID: 5698037786 Enrollment ID: I20180330000407 |
| Provider Name | Sonja Lynn Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346466877 PECOS PAC ID: 1052353737 Enrollment ID: I20180403000056 |
| Provider Name | Gertrude E Stoney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326547431 PECOS PAC ID: 1052673001 Enrollment ID: I20180403000639 |
| Provider Name | Helen P Roupas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033172911 PECOS PAC ID: 4385837806 Enrollment ID: I20180514002123 |
| Provider Name | Cassidy C Arnold |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013407493 PECOS PAC ID: 9032467576 Enrollment ID: I20180731003040 |
| Provider Name | Lauren Pointer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811481385 PECOS PAC ID: 3971852013 Enrollment ID: I20180822001579 |
| Provider Name | Jenna Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578919387 PECOS PAC ID: 8224381942 Enrollment ID: I20181026001114 |
| Provider Name | Angela Q Forand |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932160074 PECOS PAC ID: 9133203326 Enrollment ID: I20181106002655 |
| Provider Name | Austin Kuhn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245794171 PECOS PAC ID: 8022357235 Enrollment ID: I20190306001665 |
| Provider Name | Stacey Lynn Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093226789 PECOS PAC ID: 2567720592 Enrollment ID: I20190312002652 |
| Provider Name | Heather G Kranz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992284558 PECOS PAC ID: 2567794464 Enrollment ID: I20191025001501 |
| Provider Name | Patrick D Whitfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992354393 PECOS PAC ID: 3173955093 Enrollment ID: I20191114003207 |
| Provider Name | Mary Goldin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093368169 PECOS PAC ID: 4385078625 Enrollment ID: I20191219002445 |
| Provider Name | Candice M Fiorini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164999702 PECOS PAC ID: 2567892342 Enrollment ID: I20200417003158 |
| Provider Name | Donna Michele Maisano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285255497 PECOS PAC ID: 2567883234 Enrollment ID: I20200604001568 |
| Provider Name | Bret Allen Guidry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588634554 PECOS PAC ID: 5496018178 Enrollment ID: I20200902003199 |
| Provider Name | Sasa Strunjas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639179138 PECOS PAC ID: 6507806403 Enrollment ID: I20201209002367 |
| Provider Name | Rosa C Dimarco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407259245 PECOS PAC ID: 1759796048 Enrollment ID: I20210218002165 |
| Provider Name | Sherry Annette Mcadams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538721618 PECOS PAC ID: 3870992803 Enrollment ID: I20210525001406 |
| Provider Name | Michael Casey Kundert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326620436 PECOS PAC ID: 6002215795 Enrollment ID: I20210601000142 |
| Provider Name | Jillian Tuso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720657547 PECOS PAC ID: 2264839489 Enrollment ID: I20210930000298 |
| Provider Name | Lucretia Denise Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184394090 PECOS PAC ID: 7810395662 Enrollment ID: I20211007002969 |
| Provider Name | Casey Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013671171 PECOS PAC ID: 3274925003 Enrollment ID: I20220127002306 |
| Provider Name | Lisa Marie Amodio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063415909 PECOS PAC ID: 0941271951 Enrollment ID: I20220203000811 |
| Provider Name | Tamara Cafaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629330238 PECOS PAC ID: 0547409526 Enrollment ID: I20220404000036 |
| Provider Name | Kari Lynn Olsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639823388 PECOS PAC ID: 4981091220 Enrollment ID: I20220504002975 |
| Provider Name | Mallory Angela Darnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326522194 PECOS PAC ID: 4688052988 Enrollment ID: I20220527000017 |
| Provider Name | Jennifer Lee Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558788281 PECOS PAC ID: 7810375771 Enrollment ID: I20220606000018 |
| Provider Name | Mona Patricia Jafarian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841343589 PECOS PAC ID: 9335242742 Enrollment ID: I20220608000372 |
| Provider Name | Thelma Ozigbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548928419 PECOS PAC ID: 2668852393 Enrollment ID: I20220712000798 |
| Provider Name | Jon Bos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922123645 PECOS PAC ID: 0345569984 Enrollment ID: I20220804003341 |
| Provider Name | Zandra Chinae Vaughan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124370648 PECOS PAC ID: 8426274572 Enrollment ID: I20220811002500 |
| Provider Name | Shana Monique Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326356635 PECOS PAC ID: 0547413387 Enrollment ID: I20220811003903 |
| Provider Name | Eleanor T Tedesco |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700930914 PECOS PAC ID: 9638119308 Enrollment ID: I20220822001319 |
| Provider Name | Darius D Poitier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235475757 PECOS PAC ID: 3870977143 Enrollment ID: I20220906001497 |
| Provider Name | Emily Neger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184274714 PECOS PAC ID: 2466837869 Enrollment ID: I20220921003010 |
| Provider Name | Margaret Vansciver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992100028 PECOS PAC ID: 8123403433 Enrollment ID: I20220921003832 |
| Provider Name | Carlett Jethroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295465755 PECOS PAC ID: 9335525161 Enrollment ID: I20221003001224 |
| Provider Name | Maura Kathleen Castellanos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316528789 PECOS PAC ID: 3870969132 Enrollment ID: I20221012001299 |
| Provider Name | Erin Marie Dorman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235545856 PECOS PAC ID: 7315313194 Enrollment ID: I20221019001654 |
| Provider Name | Pamela J Ridley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255409132 PECOS PAC ID: 6204202930 Enrollment ID: I20221020000395 |
| Provider Name | Pilar Reyna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184086977 PECOS PAC ID: 7719277136 Enrollment ID: I20221024001050 |
| Provider Name | Davis Brigman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003332404 PECOS PAC ID: 7416326640 Enrollment ID: I20221212000237 |
| Provider Name | Melissa M Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558593392 PECOS PAC ID: 8224222070 Enrollment ID: I20221222001649 |
| Provider Name | Lisa Maria Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114290236 PECOS PAC ID: 7911377155 Enrollment ID: I20230103002990 |
| Provider Name | Katherine Chille |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336631878 PECOS PAC ID: 9032589031 Enrollment ID: I20230109002500 |
| Provider Name | Nicholas Anthony Germano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770182776 PECOS PAC ID: 2769852524 Enrollment ID: I20230112001026 |
| Provider Name | James Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881835312 PECOS PAC ID: 9234289109 Enrollment ID: I20230320002216 |
| Provider Name | Sarah B Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225383078 PECOS PAC ID: 0042676561 Enrollment ID: I20230525000647 |
| Provider Name | Maihan Aurah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942901517 PECOS PAC ID: 2466819974 Enrollment ID: I20230526001253 |
| Provider Name | Kathryn Hope |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942947494 PECOS PAC ID: 3173903077 Enrollment ID: I20230607002405 |
| Provider Name | Melanie Harris Fish |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457482994 PECOS PAC ID: 2769840115 Enrollment ID: I20230616002917 |
| Provider Name | Treasure Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023274750 PECOS PAC ID: 8123419785 Enrollment ID: I20230622002505 |
| Provider Name | Consola Lombe Esambe Lobwede |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982264784 PECOS PAC ID: 5890155204 Enrollment ID: I20230718000063 |
| Provider Name | Dale Belluscio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255466520 PECOS PAC ID: 7911062898 Enrollment ID: I20230807002464 |
| Provider Name | Melissa Ann Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316083496 PECOS PAC ID: 9234584525 Enrollment ID: I20231005002668 |
| Provider Name | Victoria Dawn Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497448484 PECOS PAC ID: 8820443336 Enrollment ID: I20231018000933 |
| Provider Name | Kellie Ann Hilker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528126513 PECOS PAC ID: 7113372699 Enrollment ID: I20231018003872 |
| Provider Name | Elizabeth Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386974400 PECOS PAC ID: 3971634817 Enrollment ID: I20231018004175 |
| Provider Name | Gretchen K B Baldwin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487433728 PECOS PAC ID: 4385090331 Enrollment ID: I20231026002763 |
| Provider Name | Ann R Drouse |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952799421 PECOS PAC ID: 5294184677 Enrollment ID: I20231211001505 |
| Provider Name | Mikala Milligan Adair |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417636739 PECOS PAC ID: 1254780638 Enrollment ID: I20231211001679 |
| Provider Name | Kendra Marie Suddeth Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265163687 PECOS PAC ID: 0648629519 Enrollment ID: I20231218002894 |
| Provider Name | Angela D Old |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245377621 PECOS PAC ID: 5698877371 Enrollment ID: I20231221000595 |
| Provider Name | Nicole Doris Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619663572 PECOS PAC ID: 0840640017 Enrollment ID: I20231229002166 |
| Provider Name | Thomas Mott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306046933 PECOS PAC ID: 4486004579 Enrollment ID: I20240102003187 |
| Provider Name | Alba L Giraldo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235486457 PECOS PAC ID: 3870944580 Enrollment ID: I20240108000445 |
| Provider Name | Carolyn Whitfield Fulmore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487766549 PECOS PAC ID: 6507192333 Enrollment ID: I20240122000580 |
| Provider Name | Theodore Ruble |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033698634 PECOS PAC ID: 9739522053 Enrollment ID: I20240202003442 |
| Provider Name | Anna a Borsic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801661079 PECOS PAC ID: 4284077017 Enrollment ID: I20240208003804 |
| Provider Name | Christopher Cosgrove |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346312568 PECOS PAC ID: 5991149023 Enrollment ID: I20240216002672 |
| Provider Name | Gabri Michelle Benson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578224234 PECOS PAC ID: 6406290048 Enrollment ID: I20240222000437 |
| Provider Name | Debbie R Dechene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336190057 PECOS PAC ID: 3870938657 Enrollment ID: I20240304000050 |
| Provider Name | Darlene D Chatman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992903702 PECOS PAC ID: 2961848114 Enrollment ID: I20240309000778 |
| Provider Name | Tawana N Hayes-newton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023493194 PECOS PAC ID: 1951747633 Enrollment ID: I20240316000168 |
| Provider Name | Teresa Q Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750988804 PECOS PAC ID: 8628489606 Enrollment ID: I20240318001394 |
| Provider Name | Debra Maxwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689714107 PECOS PAC ID: 3072839992 Enrollment ID: I20240318002133 |
| Provider Name | Deidre D Joyner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184215816 PECOS PAC ID: 6901243658 Enrollment ID: I20240318002381 |
| Provider Name | Tiffany Deanna Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457015612 PECOS PAC ID: 8022455799 Enrollment ID: I20240318003069 |
| Provider Name | Shombee Monique Marshall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386238269 PECOS PAC ID: 7416394051 Enrollment ID: I20240319002249 |
| Provider Name | Linda Bachman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619161395 PECOS PAC ID: 5294970604 Enrollment ID: I20240319002454 |
| Provider Name | Natalie Altieri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528759875 PECOS PAC ID: 3678910973 Enrollment ID: I20240321004239 |
| Provider Name | Anesha L Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043977887 PECOS PAC ID: 0648617944 Enrollment ID: I20240322000071 |
| Provider Name | Lydia M Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457585234 PECOS PAC ID: 8224476015 Enrollment ID: I20240328003304 |
| Provider Name | Sarah Katherine-brackin Zell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699464602 PECOS PAC ID: 7416395975 Enrollment ID: I20240402004302 |
| Provider Name | Julie H Risher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124499306 PECOS PAC ID: 9638517196 Enrollment ID: I20240403000016 |
| Provider Name | Ryan M. Selvig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790070878 PECOS PAC ID: 4486092905 Enrollment ID: I20240403001961 |
| Provider Name | Margaret G Malaney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871185611 PECOS PAC ID: 7719325125 Enrollment ID: I20240404001705 |
| Provider Name | Bernard Richard Tedesco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184003238 PECOS PAC ID: 6507204922 Enrollment ID: I20240404001877 |
| Provider Name | Ellen M. Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982313516 PECOS PAC ID: 4789022815 Enrollment ID: I20240409000750 |
| Provider Name | Roderick L Hollis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003977539 PECOS PAC ID: 7810335924 Enrollment ID: I20240409003385 |
| Provider Name | Courtney Truesdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144085416 PECOS PAC ID: 4880032804 Enrollment ID: I20240409003874 |
| Provider Name | Larry Pierson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528679818 PECOS PAC ID: 0648629972 Enrollment ID: I20240411000052 |
| Provider Name | Steven Jesse Jahnke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013532928 PECOS PAC ID: 5597104752 Enrollment ID: I20240419003310 |
| Provider Name | Tara a Estes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477715936 PECOS PAC ID: 0749629806 Enrollment ID: I20240422003108 |
| Provider Name | Mary E Burcham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720846967 PECOS PAC ID: 1658711601 Enrollment ID: I20240424003571 |
| Provider Name | Laura Shute |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1215220637 PECOS PAC ID: 7416397278 Enrollment ID: I20240427001950 |
| Provider Name | Lakara Profit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720863541 PECOS PAC ID: 2769822345 Enrollment ID: I20240430001388 |
| Provider Name | Latoya C.T. Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528480068 PECOS PAC ID: 3971943432 Enrollment ID: I20240501000238 |
| Provider Name | Dawn Marie Harbin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164693800 PECOS PAC ID: 5294175717 Enrollment ID: I20240501002623 |
| Provider Name | Katelyn Jean Emberton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831742535 PECOS PAC ID: 6608216932 Enrollment ID: I20240502003125 |
| Provider Name | Ari-elle Rebecca West |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528691904 PECOS PAC ID: 9537509781 Enrollment ID: I20240503003499 |
| Provider Name | Elizabeth Franchini |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457744146 PECOS PAC ID: 0244671253 Enrollment ID: I20240508001986 |
| Provider Name | Deanna M Dillard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801068143 PECOS PAC ID: 7416398805 Enrollment ID: I20240516001407 |
| Provider Name | Jessica Leigh Rojas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083110399 PECOS PAC ID: 2365883659 Enrollment ID: I20240517001470 |
| Provider Name | Carolyn Manzi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790209096 PECOS PAC ID: 0749622975 Enrollment ID: I20240520002887 |
| Provider Name | Deborah Woodberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518718030 PECOS PAC ID: 9032551080 Enrollment ID: I20240522003709 |
| Provider Name | Cherryl Nelson Wardwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609082031 PECOS PAC ID: 0042652786 Enrollment ID: I20240524003153 |
| Provider Name | Britanica N. Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376180612 PECOS PAC ID: 1951743509 Enrollment ID: I20240528002423 |
| Provider Name | Kacee L Cleveland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649689290 PECOS PAC ID: 4385086958 Enrollment ID: I20240528003031 |
| Provider Name | Belinda King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548892052 PECOS PAC ID: 2466882253 Enrollment ID: I20240606004394 |
| Provider Name | Renee M Hampton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871527549 PECOS PAC ID: 3678015492 Enrollment ID: I20240607003442 |
| Provider Name | Ashley Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356190979 PECOS PAC ID: 1153863733 Enrollment ID: I20240611002085 |
| Provider Name | Shyeasha Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073167185 PECOS PAC ID: 2961864533 Enrollment ID: I20240626001566 |
| Provider Name | Michael a Jayne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144499690 PECOS PAC ID: 9133663602 Enrollment ID: I20240626001584 |
| Provider Name | Nicole Trista Guttermuth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396313052 PECOS PAC ID: 1153865316 Enrollment ID: I20240628000046 |
| Provider Name | Amy Taylor Lowe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588144380 PECOS PAC ID: 1759825912 Enrollment ID: I20240628000171 |
| Provider Name | Yvonne Fernandez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1619548708 PECOS PAC ID: 5092259275 Enrollment ID: I20240628000726 |
| Provider Name | Kimberly Hammonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093376832 PECOS PAC ID: 5890022263 Enrollment ID: I20240701004173 |
| Provider Name | Dawn Marie Devaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710675434 PECOS PAC ID: 1759749278 Enrollment ID: I20240705000917 |
| Provider Name | Lauren Britt Adcock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528633203 PECOS PAC ID: 0042756900 Enrollment ID: I20240726003437 |
| Provider Name | Latyce K Locker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427497742 PECOS PAC ID: 7012454838 Enrollment ID: I20240730000304 |
| Provider Name | Janine Norment |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699523621 PECOS PAC ID: 0042757619 Enrollment ID: I20240731002542 |
| Provider Name | Beverly P Bennett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538307061 PECOS PAC ID: 5890232334 Enrollment ID: I20240801004532 |
| Provider Name | Charlotte Chrisp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750031837 PECOS PAC ID: 5294272563 Enrollment ID: I20240805000740 |
| Provider Name | Stephanie L Mckenny |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184395584 PECOS PAC ID: 9638616550 Enrollment ID: I20240808002785 |
| Provider Name | Michelle J Whitlow-blanding |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427720283 PECOS PAC ID: 7618415530 Enrollment ID: I20240809002680 |
| Provider Name | Nathan Donald Duchesne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417416462 PECOS PAC ID: 6608314851 Enrollment ID: I20240819002924 |
| Provider Name | Karen Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629748678 PECOS PAC ID: 9537519566 Enrollment ID: I20240820004729 |
| Provider Name | Ashley C Royer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407699051 PECOS PAC ID: 8729526785 Enrollment ID: I20240821003103 |
| Provider Name | Tashae Monique Tate-miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851784797 PECOS PAC ID: 3678012598 Enrollment ID: I20240823000534 |
| Provider Name | Victoria L Mamin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659674661 PECOS PAC ID: 7315486685 Enrollment ID: I20240830000296 |
| Provider Name | Amanda Lynn Storm |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1538238308 PECOS PAC ID: 8224579248 Enrollment ID: I20240918001363 |
| Provider Name | Kya Coreisa Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558112110 PECOS PAC ID: 3678014545 Enrollment ID: I20240918003547 |
| Provider Name | Lisa Marie Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023583630 PECOS PAC ID: 8022559723 Enrollment ID: I20240921000380 |
| Provider Name | Suzette J Depasquale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538866876 PECOS PAC ID: 1658812292 Enrollment ID: I20240923001703 |
| Provider Name | Timothy Parks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477390268 PECOS PAC ID: 9739620386 Enrollment ID: I20240923001750 |
| Provider Name | Kylie Drouin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386237998 PECOS PAC ID: 5395143911 Enrollment ID: I20240930003465 |
| Provider Name | Sharon Hudson Stevens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063163756 PECOS PAC ID: 0345772273 Enrollment ID: I20241017000349 |
| Provider Name | Charlene D Garner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902997844 PECOS PAC ID: 4486186236 Enrollment ID: I20241017001878 |
| Provider Name | Amy N Cantley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730453036 PECOS PAC ID: 2365667094 Enrollment ID: I20241022002910 |
| Provider Name | Corrie Crook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508823899 PECOS PAC ID: 7214927722 Enrollment ID: I20241024000212 |
| Provider Name | Kashun White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639419641 PECOS PAC ID: 1658804422 Enrollment ID: I20241031003083 |
| Provider Name | Rebecca a Mcvey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407522907 PECOS PAC ID: 2264966480 Enrollment ID: I20241111003871 |
| Provider Name | Candace Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679149975 PECOS PAC ID: 2961941604 Enrollment ID: I20241113000513 |
| Provider Name | Katherine Marie Bradish |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275916322 PECOS PAC ID: 1557896206 Enrollment ID: I20241119001295 |
| Provider Name | Devin Marquis Giles Myers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275127003 PECOS PAC ID: 6608301353 Enrollment ID: I20241119001448 |
| Provider Name | Racquel Lashanta Sims |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376378000 PECOS PAC ID: 8426583824 Enrollment ID: I20241121003877 |
| Provider Name | Jannat Fay Wolfe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609911726 PECOS PAC ID: 0042341901 Enrollment ID: I20241122000189 |
| Provider Name | Nancy M. Winston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881787778 PECOS PAC ID: 1153856331 Enrollment ID: I20241125002534 |
| Provider Name | Alyssa Mcelwany |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679915532 PECOS PAC ID: 8921242538 Enrollment ID: I20241126003306 |
| Provider Name | Sarah Brianna Hunter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316555865 PECOS PAC ID: 9931634052 Enrollment ID: I20241127000114 |
| Provider Name | Michael Ryan Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770851834 PECOS PAC ID: 5092177873 Enrollment ID: I20241205003006 |
| Provider Name | Porsha Kimbrough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356113252 PECOS PAC ID: 1759818685 Enrollment ID: I20241217001382 |
| Provider Name | Tracey R. Fournier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154799849 PECOS PAC ID: 0446787998 Enrollment ID: I20241220003053 |
| Provider Name | Flavia Fernicola |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467840785 PECOS PAC ID: 5698202091 Enrollment ID: I20241226000453 |
| Provider Name | Mary Jo Mcinerny |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417256785 PECOS PAC ID: 8729515739 Enrollment ID: I20250102000973 |
| Provider Name | Jessica N Nichols |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740695477 PECOS PAC ID: 8123556784 Enrollment ID: I20250109002394 |
| Provider Name | Kiavanna L Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508511809 PECOS PAC ID: 7416485792 Enrollment ID: I20250114003751 |
| Provider Name | Duncan B Howe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548086010 PECOS PAC ID: 7315476850 Enrollment ID: I20250128003806 |
| Provider Name | Sochhatta Katherine Man |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841467768 PECOS PAC ID: 8022547421 Enrollment ID: I20250130001496 |
| Provider Name | Brandyn Lee Sewers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811623143 PECOS PAC ID: 9739619958 Enrollment ID: I20250203003492 |
| Provider Name | Sarah Heath |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780400960 PECOS PAC ID: 4183154040 Enrollment ID: I20250206002532 |
| Provider Name | Candace J Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700964756 PECOS PAC ID: 0840720710 Enrollment ID: I20250206002693 |
| Provider Name | Carmen a Lucero-haines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609972140 PECOS PAC ID: 1456881135 Enrollment ID: I20250211000736 |
| Provider Name | Jessica Lyn Debolt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760150700 PECOS PAC ID: 4284154782 Enrollment ID: I20250227002496 |
| Provider Name | Kimberly D Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326570854 PECOS PAC ID: 4688196652 Enrollment ID: I20250319001819 |
| Provider Name | Thomas Howard Hutchison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205480217 PECOS PAC ID: 6103266093 Enrollment ID: I20250331000659 |
| Provider Name | Opal a Fulwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932681855 PECOS PAC ID: 2961926381 Enrollment ID: I20250408000235 |
| Provider Name | Thearica L Bright-mickle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952068124 PECOS PAC ID: 3375068117 Enrollment ID: I20250415001132 |
| Provider Name | Lotte Friend Bonneau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376344051 PECOS PAC ID: 1456877273 Enrollment ID: I20250424002312 |
| Provider Name | Tresann Sinnett Henningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487466793 PECOS PAC ID: 0345766911 Enrollment ID: I20250428000213 |
| Provider Name | Julia Dawn Mahaney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780656116 PECOS PAC ID: 1254515109 Enrollment ID: I20250505001489 |
| Provider Name | Ryan E Terrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639245673 PECOS PAC ID: 8224555628 Enrollment ID: I20250508002969 |
| Provider Name | Jessica Nettles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245085844 PECOS PAC ID: 2163940495 Enrollment ID: I20250520001116 |
| Provider Name | Rebecca Brett Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306640685 PECOS PAC ID: 9739607920 Enrollment ID: I20250521000542 |
| Provider Name | Lynn Severt Gilderhus |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1760450589 PECOS PAC ID: 3173032067 Enrollment ID: I20250603000226 |
| Provider Name | Emily Strain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174250880 PECOS PAC ID: 1456875657 Enrollment ID: I20250610000619 |
| Provider Name | Gwendolyn Grace Ferguson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689044984 PECOS PAC ID: 8628588498 Enrollment ID: I20250610003414 |
| Provider Name | Theresa Bunt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871158410 PECOS PAC ID: 3678085909 Enrollment ID: I20250623004099 |
| Provider Name | Rachel Brewster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215734207 PECOS PAC ID: 8820501919 Enrollment ID: I20250701004153 |
| Provider Name | Jason Franklin Clemons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225257298 PECOS PAC ID: 5597279570 Enrollment ID: I20250710001714 |
| Provider Name | Angela Yvette Woolridge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023894474 PECOS PAC ID: 5496261497 Enrollment ID: I20250717003051 |
| Provider Name | Brittany Boyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588020291 PECOS PAC ID: 6002194867 Enrollment ID: I20250723004484 |
| Provider Name | Amber Lynee Herbin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437850765 PECOS PAC ID: 9931615069 Enrollment ID: I20250724000142 |
| Provider Name | Robert Karpe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194611699 PECOS PAC ID: 9234646498 Enrollment ID: I20250730004542 |
| Provider Name | Lashonda Alieshia Linnen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093421422 PECOS PAC ID: 4688173933 Enrollment ID: I20250814004372 |
| Provider Name | Michael Anthony Rose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548808280 PECOS PAC ID: 1951800481 Enrollment ID: I20250820001373 |
| Provider Name | Steve Johnson Brasington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477523256 PECOS PAC ID: 6406087980 Enrollment ID: I20250904000643 |
| Provider Name | Shelby Jones-stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184290736 PECOS PAC ID: 7214439439 Enrollment ID: I20250907000329 |
| Provider Name | Joshua Taylor Freeman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174301543 PECOS PAC ID: 3375048713 Enrollment ID: I20250925003143 |
| Provider Name | Sarah Elaine Mcmullan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427930411 PECOS PAC ID: 4981109022 Enrollment ID: I20250927000703 |
| Provider Name | Shannon Murray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346620614 PECOS PAC ID: 3870082019 Enrollment ID: I20251029000631 |
| Provider Name | Madeline Mobley Eads |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316788995 PECOS PAC ID: 7315436037 Enrollment ID: I20251031000993 |
| Provider Name | Erica Neriece Whitaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518677202 PECOS PAC ID: 4789174970 Enrollment ID: I20251106001863 |
| Provider Name | Tiffany Michaela Busby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457694093 PECOS PAC ID: 7517457542 Enrollment ID: I20251106005229 |
| Provider Name | Sarah Nicole Aulbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407552805 PECOS PAC ID: 1153794458 Enrollment ID: I20251119003507 |
| Provider Name | Trent W Peeler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912666785 PECOS PAC ID: 6800389578 Enrollment ID: I20251202000728 |
| Provider Name | Lisa M Ackland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861066318 PECOS PAC ID: 9133613862 Enrollment ID: I20251210002870 |
| Provider Name | Karl Hoffmann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447441100 PECOS PAC ID: 4385174820 Enrollment ID: I20260106000527 |
| Provider Name | Sharina L Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275493637 PECOS PAC ID: 7214414549 Enrollment ID: I20260116002556 |
| Provider Name | Katrina R Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508673534 PECOS PAC ID: 7416434386 Enrollment ID: I20260122001008 |
| Provider Name | Brittney Lynn Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235416843 PECOS PAC ID: 2163909789 Enrollment ID: I20260124000067 |
| Provider Name | Lutisha Wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679340665 PECOS PAC ID: 8325526171 Enrollment ID: I20260202003055 |
| Provider Name | Emily Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912645342 PECOS PAC ID: 5092253120 Enrollment ID: I20260204002776 |
| Provider Name | Thais Teressa Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497220354 PECOS PAC ID: 7315320967 Enrollment ID: I20260204003595 |
| Provider Name | Lauren Parlato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205506029 PECOS PAC ID: 8820578263 Enrollment ID: I20260216002189 |
| Provider Name | Anne Lauren Meyers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851970537 PECOS PAC ID: 4183104938 Enrollment ID: I20260219001368 |
| Provider Name | Hannah Marie Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508296161 PECOS PAC ID: 0345720116 Enrollment ID: I20260219001889 |
| Provider Name | Abigail Mae Lust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043172166 PECOS PAC ID: 7810479995 Enrollment ID: I20260306002610 |
| Provider Name | Tera Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144197914 PECOS PAC ID: 6709360373 Enrollment ID: I20260320003404 |
| Provider Name | Jana Moser |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1790821833 PECOS PAC ID: 0446734651 Enrollment ID: I20260325000840 |
| Provider Name | Valentine Baptiste- Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396607354 PECOS PAC ID: 7517442759 Enrollment ID: I20260326001045 |
| Provider Name | Cheyenne Taylor Chewning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861271322 PECOS PAC ID: 7618452699 Enrollment ID: I20260327001338 |
| Provider Name | Cara Mcdermott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073195343 PECOS PAC ID: 9234530361 Enrollment ID: I20260331000902 |
| Provider Name | Misha Kay Gibson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356972517 PECOS PAC ID: 1759866387 Enrollment ID: I20260331003771 |
| Provider Name | Anitra Janay Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366098352 PECOS PAC ID: 6002381126 Enrollment ID: I20260407001122 |
| Provider Name | Patricia Marie Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861819187 PECOS PAC ID: 4981837341 Enrollment ID: I20260416000669 |
| Provider Name | Kirstyn Kirkland Garron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619868536 PECOS PAC ID: 7810464351 Enrollment ID: I20260422002230 |
| Provider Name | Angela Joyce Matuella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033272737 PECOS PAC ID: 0244287977 Enrollment ID: I20260508001850 |
| Provider Name | Yolonda Pawielski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437938008 PECOS PAC ID: 1759821648 Enrollment ID: I20260512002053 |
| Provider Name | Sheila a Mcgee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417553868 PECOS PAC ID: 0547739161 Enrollment ID: I20260513001314 |
| Provider Name | Amanda Acree |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871959619 PECOS PAC ID: 6305343831 Enrollment ID: I20260518001909 |
| Provider Name | Tasha Cowan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275394983 PECOS PAC ID: 9133699903 Enrollment ID: I20260522000129 |
| Provider Name | Rico Montineze Hogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871363481 PECOS PAC ID: 1759851991 Enrollment ID: I20260528002544 |
| Provider Name | Ashley Childs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508623612 PECOS PAC ID: 1951818947 Enrollment ID: I20260528002603 |
| Provider Name | Karli Marie Kilby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114537461 PECOS PAC ID: 0648741256 Enrollment ID: I20260604002346 |
| Provider Name | Saquia Mcneil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033846019 PECOS PAC ID: 4981175478 Enrollment ID: I20260605000536 |
| Provider Name | Jessica Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952929598 PECOS PAC ID: 5597182022 Enrollment ID: I20260608001643 |
| Provider Name | Marlayah Elliosha Legare |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457968463 PECOS PAC ID: 7911479910 Enrollment ID: I20260610002917 |
| Provider Name | Marialyn Chowansky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467109009 PECOS PAC ID: 7416429329 Enrollment ID: I20260611002370 |
| Provider Name | Heather Lynn Gates |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275148066 PECOS PAC ID: 9133691058 Enrollment ID: I20260611002815 |
| Provider Name | Bonnetta Hall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225513203 PECOS PAC ID: 7719450816 Enrollment ID: I20260619001732 |
| Provider Name | Devon Sautman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225773443 PECOS PAC ID: 6305314303 Enrollment ID: I20260623001874 |
| Provider Name | Maire Claire Diemer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609737931 PECOS PAC ID: 1951874502 Enrollment ID: I20260624004402 |
| Provider Name | Shiloh Sears |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811771660 PECOS PAC ID: 3274006507 Enrollment ID: I20260626003249 |
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