| Community Mental Health Authority Of Clinton Eaton Ingham Counties | |
|
812 E Jolly Road Lansing MI 48910-6821 | |
| (517) 346-8200 | |
| (517) 346-8291 |
| Full Name | Community Mental Health Authority Of Clinton Eaton Ingham Counties |
|---|---|
| Speciality | Clinic/Center |
| Location | 812 E Jolly Road, Lansing, Michigan |
| Authorized Official Name and Position | Sara Lurie (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5173468212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Mental Health Authority Of Clinton Eaton Ingham Counties 812 E Jolly Road Suite 210 Lansing MI 48910-6821 Ph: (517) 346-8119 | Community Mental Health Authority Of Clinton Eaton Ingham Counties 812 E Jolly Road Lansing MI 48910-6821 Ph: (517) 346-8200 |
| NPI Number | 1265483457 |
|---|---|
| Provider Enumeration Date | 05/13/2006 |
| Last Update Date | 03/11/2020 |
| Certification Date | 03/11/2020 |
| Medicare PECOS PAC ID | 2668376732 |
|---|---|
| Medicare Enrollment ID | O20031120000698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265483457 | NPI | - | NPPES |
| 21-1708001 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | John A Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548225519 PECOS PAC ID: 4183616295 Enrollment ID: I20040331000126 |
| Provider Name | David N Vigor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235144940 PECOS PAC ID: 4981688389 Enrollment ID: I20040616000015 |
| Provider Name | Louis C Anstett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144282658 PECOS PAC ID: 1052396256 Enrollment ID: I20040622000760 |
| Provider Name | Dale A Dmello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487751723 PECOS PAC ID: 4183609944 Enrollment ID: I20040624000218 |
| Provider Name | Jimmie L Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578539128 PECOS PAC ID: 7012984941 Enrollment ID: I20040910001188 |
| Provider Name | Carol Leader |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659337301 PECOS PAC ID: 0749237477 Enrollment ID: I20050405001049 |
| Provider Name | Paul Y Liu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427014562 PECOS PAC ID: 6709828288 Enrollment ID: I20050525000197 |
| Provider Name | Jennifer Lynne Stanley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972560852 PECOS PAC ID: 2062437890 Enrollment ID: I20051011000849 |
| Provider Name | Sarah Susannah Zyskowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144240136 PECOS PAC ID: 8527076249 Enrollment ID: I20060322000396 |
| Provider Name | Danial J Zak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417164575 PECOS PAC ID: 8729161005 Enrollment ID: I20080208000504 |
| Provider Name | Alisa M Schlacht |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205043353 PECOS PAC ID: 5496809840 Enrollment ID: I20090819000426 |
| Provider Name | Lauren F Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396949319 PECOS PAC ID: 0941496400 Enrollment ID: I20101123000267 |
| Provider Name | Cynthia L Spencer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053361089 PECOS PAC ID: 6901089689 Enrollment ID: I20110318000384 |
| Provider Name | Joel M Sanchez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104147511 PECOS PAC ID: 0547415424 Enrollment ID: I20130226000144 |
| Provider Name | Heather Mcclelland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548432024 PECOS PAC ID: 2062644198 Enrollment ID: I20140403002031 |
| Provider Name | Sacheen Shrestha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669622197 PECOS PAC ID: 7214109933 Enrollment ID: I20161117000300 |
| Provider Name | Jamie Lee Lussier Arnold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568757714 PECOS PAC ID: 2860774585 Enrollment ID: I20170112002428 |
| Provider Name | Samantha Kennedy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154760312 PECOS PAC ID: 1850661679 Enrollment ID: I20170726002725 |
| Provider Name | Rita M Aouad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164777926 PECOS PAC ID: 9133369200 Enrollment ID: I20190112000272 |
| Provider Name | Jenna Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336669035 PECOS PAC ID: 8123453214 Enrollment ID: I20200117001741 |
| Provider Name | Sin Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912387770 PECOS PAC ID: 9830510205 Enrollment ID: I20200611000454 |
| Provider Name | Anita Iype |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639598907 PECOS PAC ID: 1557581089 Enrollment ID: I20200611000498 |
| Provider Name | Afiah A Ahsan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326380783 PECOS PAC ID: 0941574834 Enrollment ID: I20200708002592 |
| Provider Name | Zane Gregory Meibeyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881123313 PECOS PAC ID: 7618245762 Enrollment ID: I20211019000339 |
| Provider Name | Krishna S Vempati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710412457 PECOS PAC ID: 3779968441 Enrollment ID: I20220915002894 |
| Provider Name | Hien Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982139325 PECOS PAC ID: 5092187849 Enrollment ID: I20230206000164 |
| Provider Name | Karla Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275780819 PECOS PAC ID: 6800030404 Enrollment ID: I20230210001076 |
| Provider Name | Jacob Robert Aubry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326539776 PECOS PAC ID: 1456724939 Enrollment ID: I20230303000165 |
| Provider Name | Saadia Ajmal Sheikh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316108160 PECOS PAC ID: 2264583962 Enrollment ID: I20230410000442 |
| Provider Name | Lisa Catherine Gates |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073176079 PECOS PAC ID: 4183089659 Enrollment ID: I20230505001384 |
| Provider Name | Roberto Zayas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780085407 PECOS PAC ID: 0244207066 Enrollment ID: I20230531002276 |
| Provider Name | Angela Harrison Brantley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659381127 PECOS PAC ID: 5193753382 Enrollment ID: I20230606002588 |
| Provider Name | Bryan E Bolen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548820467 PECOS PAC ID: 6709245418 Enrollment ID: I20230628003400 |
| Provider Name | Alberto Tamayo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548882665 PECOS PAC ID: 2365803335 Enrollment ID: I20230807003787 |
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