| Commerce Psychiatric Services Plc | |
|
55 North Pond Drive Suite 6 Walled Lake MI 48390 | |
| (248) 669-1900 | |
| (248) 669-1925 |
| Full Name | Commerce Psychiatric Services Plc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 55 North Pond Drive, Walled Lake, Michigan |
| Authorized Official Name and Position | Bruce Leland Roth (OWNER) |
| Authorized Official Contact | 2483606102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commerce Psychiatric Services Plc 55 North Pond Drive Suite 6 Walled Lake MI 48390 Ph: (248) 669-1900 | Commerce Psychiatric Services Plc 55 North Pond Drive Suite 6 Walled Lake MI 48390 Ph: (248) 669-1900 |
| NPI Number | 1134203896 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 07/19/2007 |
| Medicare PECOS PAC ID | 6204923519 |
|---|---|
| Medicare Enrollment ID | O20071102000660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134203896 | NPI | - | NPPES |
| 2656300704 | Other | BCBS MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Michigan) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (Michigan) | Secondary |
| Provider Name | Bruce Roth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093841017 PECOS PAC ID: 2769579077 Enrollment ID: I20071102000655 |
| Provider Name | Eva M Gadd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750561395 PECOS PAC ID: 3476634866 Enrollment ID: I20080110000705 |
| Provider Name | Diane M Fischer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346451697 PECOS PAC ID: 8224186499 Enrollment ID: I20090427000390 |
| Provider Name | Karen E Stearns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588945554 PECOS PAC ID: 2062703317 Enrollment ID: I20160616002595 |
| Provider Name | Lydia C Ditirro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285950212 PECOS PAC ID: 4688986102 Enrollment ID: I20160711001166 |
| Provider Name | Anne Arnolda Zamler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033659644 PECOS PAC ID: 3870495153 Enrollment ID: I20180115000559 |
| Provider Name | Deborah F Bienstock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639637283 PECOS PAC ID: 7113268566 Enrollment ID: I20190411001550 |
| Provider Name | Takako Benn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932596731 PECOS PAC ID: 9335473321 Enrollment ID: I20190625002569 |
| Provider Name | Emily Alberta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598347601 PECOS PAC ID: 8426448721 Enrollment ID: I20211130002510 |
| Provider Name | Lindsey R Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508572322 PECOS PAC ID: 7416322391 Enrollment ID: I20230406000561 |
| Provider Name | Ryan R Harms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396378964 PECOS PAC ID: 7719334291 Enrollment ID: I20231104000304 |
| Provider Name | Angela G Chernyak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568244267 PECOS PAC ID: 5193173144 Enrollment ID: I20231130003221 |
| Provider Name | Kathryn J Mikol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396492922 PECOS PAC ID: 1759730526 Enrollment ID: I20231206001174 |
Palliative Medicine Associates Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2346 S Commerce Rd, Walled Lake, MI 48390 Phone: 810-923-4485 Fax: 248-849-2834 | |
Oakland Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2045 East West Maple Road, Suite D-407, Walled Lake, MI 48390 Phone: 248-624-3811 Fax: 248-624-0368 | |
Susan H. Deutsch Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 N Pond Dr, Suite 6, Walled Lake, MI 48390 Phone: 248-669-1900 Fax: 248-669-1925 | |
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