| Creative Health Services, Inc. | |
|
929 Willow St Pottstown PA 19464-1811 | |
| (610) 326-7734 | |
| (610) 326-4762 |
| Full Name | Creative Health Services, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 929 Willow St, Pottstown, Pennsylvania |
| Authorized Official Name and Position | P. Andrew Trentacoste (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4849410500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Health Services, Inc. 11 Robinson St Pottstown PA 19464-6421 Ph: (484) 941-0500 | Creative Health Services, Inc. 929 Willow St Pottstown PA 19464-1811 Ph: (610) 326-7734 |
| NPI Number | 1124194121 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 03/01/2019 |
| Medicare PECOS PAC ID | 2365340528 |
|---|---|
| Medicare Enrollment ID | O20040109000892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124194121 | NPI | - | NPPES |
| 100751163 | Medicaid | PA |
| Provider Name | Robert B Chambliss |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780611202 PECOS PAC ID: 6507833910 Enrollment ID: I20040915000283 |
| Provider Name | Michael Dorfman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629060587 PECOS PAC ID: 9830123900 Enrollment ID: I20050920000068 |
| Provider Name | Karen G Newman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508997180 PECOS PAC ID: 8022194604 Enrollment ID: I20080324000229 |
| Provider Name | Mario A Ercole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891891008 PECOS PAC ID: 3577649169 Enrollment ID: I20080324000343 |
| Provider Name | Gail Corrado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780899187 PECOS PAC ID: 2567534472 Enrollment ID: I20080710000167 |
| Provider Name | Tanya F Kirby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740493022 PECOS PAC ID: 1153498837 Enrollment ID: I20080922000557 |
| Provider Name | Donna J Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114259512 PECOS PAC ID: 8628266459 Enrollment ID: I20101221000764 |
| Provider Name | Bernard Amiel Harris |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1619081726 PECOS PAC ID: 0345419156 Enrollment ID: I20110812000317 |
| Provider Name | Anna C Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083978001 PECOS PAC ID: 1557517810 Enrollment ID: I20120802000320 |
| Provider Name | Valerie P Vitale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598195851 PECOS PAC ID: 2264741677 Enrollment ID: I20151027000654 |
| Provider Name | Nancy L Mullen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972928869 PECOS PAC ID: 7214231109 Enrollment ID: I20160215000163 |
| Provider Name | Renee A Denobrega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316263882 PECOS PAC ID: 9739403056 Enrollment ID: I20171106001543 |
| Provider Name | Adjoa Amoah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942710660 PECOS PAC ID: 8022378264 Enrollment ID: I20180207001549 |
| Provider Name | Edward Francis Caruso |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780658864 PECOS PAC ID: 5496842775 Enrollment ID: I20180626000062 |
| Provider Name | Tiffany D Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902294325 PECOS PAC ID: 1850647405 Enrollment ID: I20180712000007 |
| Provider Name | Krystine Carter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831499706 PECOS PAC ID: 8820054018 Enrollment ID: I20181106001207 |
| Provider Name | William E Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316258064 PECOS PAC ID: 5799023800 Enrollment ID: I20190215000886 |
| Provider Name | Lauren Resch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033570957 PECOS PAC ID: 8325386238 Enrollment ID: I20190218002665 |
| Provider Name | Robert Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790141778 PECOS PAC ID: 6709128085 Enrollment ID: I20190507002551 |
| Provider Name | Shawn O Aikens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740823970 PECOS PAC ID: 6002249117 Enrollment ID: I20191204000087 |
| Provider Name | Tanja Gustafson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700309283 PECOS PAC ID: 5496171167 Enrollment ID: I20200812003430 |
| Provider Name | Laurie Beson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588025688 PECOS PAC ID: 7214353820 Enrollment ID: I20200813001262 |
| Provider Name | Heather R Hudock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265894547 PECOS PAC ID: 4880093764 Enrollment ID: I20210526000281 |
| Provider Name | Katharine P Wenocur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285018135 PECOS PAC ID: 7719366079 Enrollment ID: I20220617000409 |
| Provider Name | Sandra L Bamford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265184576 PECOS PAC ID: 4385023548 Enrollment ID: I20220617000728 |
| Provider Name | Wilmarie Montero-negron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548965262 PECOS PAC ID: 8921467804 Enrollment ID: I20230711000244 |
| Provider Name | Kala Fell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1922427699 PECOS PAC ID: 9931558772 Enrollment ID: I20231205004048 |
| Provider Name | Stacie Courtney Mustaphi |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407204670 PECOS PAC ID: 9436509254 Enrollment ID: I20231220000863 |
| Provider Name | Katlyn Walters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801556352 PECOS PAC ID: 8022469642 Enrollment ID: I20240109000329 |
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