| County Of Macomb | |
|
43740 N Groesbeck Hwy Clinton Twp MI 48036-1139 | |
| (586) 469-7929 | |
| (586) 469-7664 |
| Full Name | County Of Macomb |
|---|---|
| Speciality | Clinic/Center |
| Location | 43740 N Groesbeck Hwy, Clinton Twp, Michigan |
| Authorized Official Name and Position | Norma Josef (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5864658322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Macomb 19800 Hall Rd Clinton Twp MI 48038-5318 Ph: (855) 996-2264 | County Of Macomb 43740 N Groesbeck Hwy Clinton Twp MI 48036-1139 Ph: (586) 469-7929 |
| NPI Number | 1942532197 |
|---|---|
| Provider Enumeration Date | 02/12/2010 |
| Last Update Date | 09/05/2025 |
| Certification Date | 09/05/2025 |
| Medicare PECOS PAC ID | 4880581404 |
|---|---|
| Medicare Enrollment ID | O20040301000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942532197 | NPI | - | NPPES |
| 260E07664 | Other | MI | REGULAR BUSINESS BC |
| 3396315 | Medicaid | MI | |
| 750910560 | Other | MI | BC OPC |
| 750911560 | Other | MI | BC OPC |
| 750912560 | Other | MI | BC OPC |
| 750913560 | Other | MI | BC OPC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gary K Ralph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689640237 PECOS PAC ID: 4587562574 Enrollment ID: I20031229000807 |
| Provider Name | Orlena B Merritt Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982632824 PECOS PAC ID: 4284535766 Enrollment ID: I20040309001292 |
| Provider Name | Venkata R Jasty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184661670 PECOS PAC ID: 6608861844 Enrollment ID: I20040417000267 |
| Provider Name | Kehinde A Ayeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366520470 PECOS PAC ID: 8729073580 Enrollment ID: I20040420000261 |
| Provider Name | Phillip J Archer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487780672 PECOS PAC ID: 7719978790 Enrollment ID: I20040519000703 |
| Provider Name | Nilanjan B Gajare |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972616191 PECOS PAC ID: 5597747550 Enrollment ID: I20040603000373 |
| Provider Name | Antonio H Nucum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164431540 PECOS PAC ID: 2062495526 Enrollment ID: I20040608000354 |
| Provider Name | John V Baugh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932216835 PECOS PAC ID: 4082680756 Enrollment ID: I20040903000197 |
| Provider Name | Majid Pezhman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538257688 PECOS PAC ID: 2365410859 Enrollment ID: I20040922000715 |
| Provider Name | Someswara N Navuluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669419156 PECOS PAC ID: 6507835386 Enrollment ID: I20040928001265 |
| Provider Name | Lily A Tencza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740206168 PECOS PAC ID: 3476516196 Enrollment ID: I20041104000366 |
| Provider Name | Ancuta Elena Matei |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982641544 PECOS PAC ID: 5294790614 Enrollment ID: I20041124000887 |
| Provider Name | Christine M Post |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528161981 PECOS PAC ID: 8820040611 Enrollment ID: I20050221000540 |
| Provider Name | Lisa Renee Haston-fuller |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1831298397 PECOS PAC ID: 3870549355 Enrollment ID: I20050328000951 |
| Provider Name | Jonathan P Beard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417998972 PECOS PAC ID: 6002859220 Enrollment ID: I20050608000265 |
| Provider Name | Edgard Pedraza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881881324 PECOS PAC ID: 8820022072 Enrollment ID: I20050927000162 |
| Provider Name | Stephanie A Riolo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942237425 PECOS PAC ID: 0840217170 Enrollment ID: I20051026000886 |
| Provider Name | Deanna M Freed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104969930 PECOS PAC ID: 1759397649 Enrollment ID: I20060301000801 |
| Provider Name | Natraj Sitaram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518904176 PECOS PAC ID: 9739191065 Enrollment ID: I20060630000317 |
| Provider Name | Susha Panicker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558410787 PECOS PAC ID: 3274535042 Enrollment ID: I20070207000249 |
| Provider Name | Charles H Lapo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285674028 PECOS PAC ID: 8820001142 Enrollment ID: I20070406000148 |
| Provider Name | Hashim Raza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881813541 PECOS PAC ID: 2961594130 Enrollment ID: I20070816000866 |
| Provider Name | Jill D Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598958043 PECOS PAC ID: 4981790052 Enrollment ID: I20071020000030 |
| Provider Name | Yolanda D Giles |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1942382502 PECOS PAC ID: 1254408446 Enrollment ID: I20080930000689 |
| Provider Name | Robert Lagrou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629279351 PECOS PAC ID: 3779645270 Enrollment ID: I20081217000396 |
| Provider Name | Suzan C Robarge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104848530 PECOS PAC ID: 3375691595 Enrollment ID: I20090428000209 |
| Provider Name | Lubna S Izzathullah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730372228 PECOS PAC ID: 6800983248 Enrollment ID: I20090622000587 |
| Provider Name | Samuel A Klein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508955733 PECOS PAC ID: 5597762492 Enrollment ID: I20090714000232 |
| Provider Name | Anita M Schierlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720220312 PECOS PAC ID: 9537212667 Enrollment ID: I20090806000351 |
| Provider Name | Jillaine Ruppel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780816520 PECOS PAC ID: 9931255106 Enrollment ID: I20090914000607 |
| Provider Name | Wisam A Salman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972706133 PECOS PAC ID: 6305983701 Enrollment ID: I20091016000120 |
| Provider Name | Humera Athar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073720900 PECOS PAC ID: 4486794153 Enrollment ID: I20091211000086 |
| Provider Name | Nagaprasad B Murthi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326132093 PECOS PAC ID: 6800088931 Enrollment ID: I20101007001262 |
| Provider Name | Renee Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043350895 PECOS PAC ID: 4688861198 Enrollment ID: I20101209001019 |
| Provider Name | Sylvia D Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962509661 PECOS PAC ID: 5597944637 Enrollment ID: I20110121000560 |
| Provider Name | Teresa M Chahine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255631875 PECOS PAC ID: 7416125133 Enrollment ID: I20110725000642 |
| Provider Name | Susan M Stine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881631372 PECOS PAC ID: 9830347111 Enrollment ID: I20120911000431 |
| Provider Name | Jennifer A Vinch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275769762 PECOS PAC ID: 0547410102 Enrollment ID: I20121017000670 |
| Provider Name | Sandra K Deering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962500397 PECOS PAC ID: 9335390426 Enrollment ID: I20121120000231 |
| Provider Name | Shirley G Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235419599 PECOS PAC ID: 3971749185 Enrollment ID: I20130412000604 |
| Provider Name | Belal Hegazy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205103793 PECOS PAC ID: 5092956409 Enrollment ID: I20130729000123 |
| Provider Name | Jennifer Wims-madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245585710 PECOS PAC ID: 0143450437 Enrollment ID: I20140306001427 |
| Provider Name | Colleen M Biafore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558788133 PECOS PAC ID: 0244462638 Enrollment ID: I20140417001833 |
| Provider Name | Dayna J Leplatte-ogini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225299621 PECOS PAC ID: 6406072008 Enrollment ID: I20140716001783 |
| Provider Name | Meghan E Slater |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871877092 PECOS PAC ID: 9739308719 Enrollment ID: I20140924001933 |
| Provider Name | Don Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528155850 PECOS PAC ID: 9638136799 Enrollment ID: I20141015001981 |
| Provider Name | Amelia C Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073878674 PECOS PAC ID: 5799076873 Enrollment ID: I20160621000558 |
| Provider Name | Kimberly Poirier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588065098 PECOS PAC ID: 4183917453 Enrollment ID: I20160725000488 |
| Provider Name | Raymelle M Schoos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033211545 PECOS PAC ID: 9133191851 Enrollment ID: I20160804000802 |
| Provider Name | Trina Mason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992258362 PECOS PAC ID: 9234423377 Enrollment ID: I20160811001833 |
| Provider Name | Ammar H Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669797627 PECOS PAC ID: 7719124262 Enrollment ID: I20160916001792 |
| Provider Name | Hannah Villapando |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740783612 PECOS PAC ID: 1850653965 Enrollment ID: I20180328003061 |
| Provider Name | Jeffrey P Guina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073827275 PECOS PAC ID: 4587892039 Enrollment ID: I20180523002089 |
| Provider Name | Anne W Spina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679960579 PECOS PAC ID: 2264734292 Enrollment ID: I20181030001793 |
| Provider Name | Jessica Klemanski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033613435 PECOS PAC ID: 3779837364 Enrollment ID: I20181119000126 |
| Provider Name | Myele L Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164998431 PECOS PAC ID: 3971848136 Enrollment ID: I20181218000072 |
| Provider Name | Shiba L Nixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679041545 PECOS PAC ID: 6002151578 Enrollment ID: I20190103000573 |
| Provider Name | Kimberly Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386088763 PECOS PAC ID: 6406191998 Enrollment ID: I20190103001170 |
| Provider Name | Natalie Sadik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609262948 PECOS PAC ID: 5193027951 Enrollment ID: I20190713000042 |
| Provider Name | Chelsea Nick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861048829 PECOS PAC ID: 0345579678 Enrollment ID: I20190911000986 |
| Provider Name | Mayche Vang-kue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659919819 PECOS PAC ID: 2062849938 Enrollment ID: I20200305002584 |
| Provider Name | Yanyan Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043806045 PECOS PAC ID: 8022422864 Enrollment ID: I20210205001699 |
| Provider Name | Kara N Hunter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942664644 PECOS PAC ID: 8921390469 Enrollment ID: I20210804000213 |
| Provider Name | Tricia J Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548623887 PECOS PAC ID: 3779915897 Enrollment ID: I20211130000432 |
| Provider Name | Kevin P Bautel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598428856 PECOS PAC ID: 1759771389 Enrollment ID: I20211214000865 |
| Provider Name | Preya Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649581414 PECOS PAC ID: 0547586745 Enrollment ID: I20211228002261 |
| Provider Name | Carall Fillinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699317461 PECOS PAC ID: 3072904853 Enrollment ID: I20220105002241 |
| Provider Name | Julie Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477692861 PECOS PAC ID: 7911390786 Enrollment ID: I20220201000158 |
| Provider Name | Christopher M Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790343887 PECOS PAC ID: 7214261213 Enrollment ID: I20220331000409 |
| Provider Name | Maria R Rios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871600288 PECOS PAC ID: 5395830715 Enrollment ID: I20220426000219 |
| Provider Name | Melissa Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922538941 PECOS PAC ID: 1052790458 Enrollment ID: I20220615000684 |
| Provider Name | Migdalia Fort |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467592881 PECOS PAC ID: 2769666866 Enrollment ID: I20220823001431 |
| Provider Name | Tina Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902936768 PECOS PAC ID: 4082654371 Enrollment ID: I20221207001322 |
| Provider Name | Annissa Rosser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285290536 PECOS PAC ID: 9830560457 Enrollment ID: I20230118002504 |
| Provider Name | Nilo Elizalde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841854635 PECOS PAC ID: 0648641845 Enrollment ID: I20230126001735 |
| Provider Name | Leslie Tackitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720706336 PECOS PAC ID: 6002289527 Enrollment ID: I20230303001880 |
| Provider Name | Jacqulyn Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285092445 PECOS PAC ID: 0244695963 Enrollment ID: I20230503000572 |
| Provider Name | Emily Wiese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073114260 PECOS PAC ID: 8820453327 Enrollment ID: I20230506000320 |
| Provider Name | Amy Kathleen Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346954831 PECOS PAC ID: 9032574413 Enrollment ID: I20230509000534 |
| Provider Name | Kala Pozivilko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669042990 PECOS PAC ID: 0345638052 Enrollment ID: I20230712003074 |
| Provider Name | Berenese B Canady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053616292 PECOS PAC ID: 0143479642 Enrollment ID: I20230814003226 |
| Provider Name | Theresa Lynne Harpold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639160336 PECOS PAC ID: 8426137589 Enrollment ID: I20230822003271 |
| Provider Name | Liza Marie Zimmerman-slayton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619548906 PECOS PAC ID: 5698164101 Enrollment ID: I20230901001952 |
| Provider Name | Deidre L Richards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326119884 PECOS PAC ID: 2163464504 Enrollment ID: I20231023001701 |
| Provider Name | Lloyd D Bellah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770575177 PECOS PAC ID: 1850492703 Enrollment ID: I20231027000529 |
| Provider Name | Adrian Emerick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104240175 PECOS PAC ID: 4981052404 Enrollment ID: I20231122000747 |
| Provider Name | Jessica Kapral |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821389610 PECOS PAC ID: 6103274485 Enrollment ID: I20231127002719 |
| Provider Name | Joy Anne Torres |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679932230 PECOS PAC ID: 8123477742 Enrollment ID: I20231207003641 |
| Provider Name | Masuma Jinnat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164040382 PECOS PAC ID: 9335598515 Enrollment ID: I20231213002082 |
| Provider Name | Howard Chang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811632433 PECOS PAC ID: 9234589110 Enrollment ID: I20231219003007 |
| Provider Name | Brooklynn Samantha Dimit-helzer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154923027 PECOS PAC ID: 6002267630 Enrollment ID: I20240109000819 |
| Provider Name | Bronwyn Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457872822 PECOS PAC ID: 0941653596 Enrollment ID: I20240130003058 |
| Provider Name | Lynn Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881042984 PECOS PAC ID: 2769835206 Enrollment ID: I20240131002572 |
| Provider Name | Kenneth York |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215236328 PECOS PAC ID: 8921451428 Enrollment ID: I20240131004542 |
| Provider Name | Helema Ballard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407196439 PECOS PAC ID: 1759734601 Enrollment ID: I20240201000401 |
| Provider Name | Serena Boldiszar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487079893 PECOS PAC ID: 2163867326 Enrollment ID: I20240227002637 |
| Provider Name | Kerry Mashburn Devee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992942908 PECOS PAC ID: 7517302623 Enrollment ID: I20240228003849 |
| Provider Name | Katie Lord |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477947901 PECOS PAC ID: 0345685327 Enrollment ID: I20240229001622 |
| Provider Name | Phyllis Walter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538262480 PECOS PAC ID: 9032560172 Enrollment ID: I20240318000611 |
| Provider Name | Briana N Mcneal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659897742 PECOS PAC ID: 6608213277 Enrollment ID: I20240319003086 |
| Provider Name | Raymond Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841739133 PECOS PAC ID: 4385081611 Enrollment ID: I20240322001245 |
| Provider Name | Kelley Noelle Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699114207 PECOS PAC ID: 6406293604 Enrollment ID: I20240323000372 |
| Provider Name | Taneisha Mackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750153763 PECOS PAC ID: 7517304553 Enrollment ID: I20240326001591 |
| Provider Name | Stephanie Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629380332 PECOS PAC ID: 5991143786 Enrollment ID: I20240328003155 |
| Provider Name | India R Mooney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184272791 PECOS PAC ID: 9638517766 Enrollment ID: I20240409000581 |
| Provider Name | Luke M Tolnai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285485342 PECOS PAC ID: 5890133854 Enrollment ID: I20240410000250 |
| Provider Name | Roba H Elkhalil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225394026 PECOS PAC ID: 4486886116 Enrollment ID: I20240430000348 |
| Provider Name | Lisa Marie Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346927969 PECOS PAC ID: 7810337078 Enrollment ID: I20240504000294 |
| Provider Name | Shakesha Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154882918 PECOS PAC ID: 2466999149 Enrollment ID: I20240730003425 |
| Provider Name | Lindsay Elizabeth Vegezzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518580836 PECOS PAC ID: 2769921907 Enrollment ID: I20240830003705 |
| Provider Name | Maria J Vega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598811937 PECOS PAC ID: 1254405475 Enrollment ID: I20241022001952 |
| Provider Name | Katie Depanfilis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669002895 PECOS PAC ID: 7416395199 Enrollment ID: I20250311000636 |
| Provider Name | Kate Frikken |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952749285 PECOS PAC ID: 2163945775 Enrollment ID: I20250325000127 |
| Provider Name | Adrianne Hawkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891324364 PECOS PAC ID: 5698293660 Enrollment ID: I20250514001895 |
Silver Circle Counseling And Therapeutic Services, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 16477 Andover Ct, Clinton Twp, MI 48035 Phone: 586-206-9270 | |
Holly Nabozny Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 36389 Harper Ave, Clinton Twp, MI 48035 Phone: 248-219-8756 | |
Baddigam Family Psychiatric Assoc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15500 19 Mile Rd, Ste 310, Clinton Twp, MI 48038 Phone: 586-263-6812 | |
Center For Effective Living Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 42657 Garfield Rd, Ste 213, Clinton Twp, MI 48038 Phone: 586-228-8838 Fax: 586-228-0813 | |
Judith K Moon Lmsw Acsw Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 37399 Garfield Rd Ste 200, Clinton Twp, MI 48036 Phone: 586-421-5164 Fax: 586-421-5179 | |
Fedor Opochinsky M.d. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15855 19 Mile Rd, Clinton Twp, MI 48038 Phone: 586-466-9939 Fax: 586-466-9956 | |
Lacey Trent Lmsw Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 37400 Garfield Rd Ste 110, Clinton Twp, MI 48036 Phone: 562-652-9744 |