| Cooperative Care Partnership, Inc | |
|
1076 Route 47 S Rio Grande NJ 08242-1608 | |
| (609) 741-6363 | |
| Not Available |
| Full Name | Cooperative Care Partnership, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1076 Route 47 S, Rio Grande, New Jersey |
| Authorized Official Name and Position | Shanna Learn (MENTAL HEALTH THERAPIST/PARTNER) |
| Authorized Official Contact | 8145043514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooperative Care Partnership, Inc 1076 Route 47 S Rio Grande NJ 08242-1608 Ph: (609) 741-6363 | Cooperative Care Partnership, Inc 1076 Route 47 S Rio Grande NJ 08242-1608 Ph: (609) 741-6363 |
| NPI Number | 1477898096 |
|---|---|
| Provider Enumeration Date | 12/07/2012 |
| Last Update Date | 05/20/2016 |
| Medicare PECOS PAC ID | 8224351606 |
|---|---|
| Medicare Enrollment ID | O20141217000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477898096 | NPI | - | NPPES |
| Provider Name | Patti C Fellows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922101013 PECOS PAC ID: 7618950528 Enrollment ID: I20040611000103 |
| Provider Name | Victoria A Wells-manlandro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386974988 PECOS PAC ID: 6103873856 Enrollment ID: I20050405000431 |
| Provider Name | Diane R Flannegan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134323447 PECOS PAC ID: 5092755389 Enrollment ID: I20050505000796 |
| Provider Name | Charles Dick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639263882 PECOS PAC ID: 7315083201 Enrollment ID: I20091007000146 |
| Provider Name | Michelle K Keating |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104283639 PECOS PAC ID: 1759665920 Enrollment ID: I20170307001943 |
| Provider Name | Eileen Stengel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851688691 PECOS PAC ID: 1355563016 Enrollment ID: I20180904001079 |
| Provider Name | Ruth S Mackenzie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720785553 PECOS PAC ID: 6507202876 Enrollment ID: I20240308001043 |
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Cooperative Care Partnership, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1076 Route 47 S, Rio Grande, NJ 08242 Phone: 609-741-6363 Fax: 609-435-5058 | |
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