| Elite Dna Therapy Services | |
|
4310 Metro Pkwy Ste 205 Fort Myers FL 33916-9416 | |
| (239) 223-2751 | |
| (239) 561-2933 |
| Full Name | Elite Dna Therapy Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 4310 Metro Pkwy Ste 205, Fort Myers, Florida |
| Authorized Official Name and Position | Elizabeth Dosoretz (PRESIDENT) |
| Authorized Official Contact | 2392232751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dna Therapy Services 4310 Metro Pkwy Ste 205 Fort Myers FL 33916-9416 Ph: (239) 223-2751 | Elite Dna Therapy Services 4310 Metro Pkwy Ste 205 Fort Myers FL 33916-9416 Ph: (239) 223-2751 |
| NPI Number | 1316363757 |
|---|---|
| Provider Enumeration Date | 03/10/2014 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 2860619632 |
|---|---|
| Medicare Enrollment ID | O20140819001276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316363757 | NPI | - | NPPES |
| 010784000 | Medicaid | FL | |
| 017439500 | Medicaid | FL | |
| 010785500 | Medicaid | FL | |
| 010785506 | Medicaid | FL | |
| 022832900 | Medicaid | FL | |
| 010785504 | Medicaid | FL | |
| 010785509 | Medicaid | FL | |
| 010785508 | Medicaid | FL |
| Provider Name | Felicia M Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063752921 PECOS PAC ID: 7810801792 Enrollment ID: I20031114000481 |
| Provider Name | Pradeep Arora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366466476 PECOS PAC ID: 6103816699 Enrollment ID: I20040518000602 |
| Provider Name | Omar Rieche |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629162813 PECOS PAC ID: 0749241636 Enrollment ID: I20041025000060 |
| Provider Name | Carol L Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063600633 PECOS PAC ID: 7517910623 Enrollment ID: I20050303000713 |
| Provider Name | Juan C Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205031853 PECOS PAC ID: 6204876733 Enrollment ID: I20050504000659 |
| Provider Name | Judith A Tiberia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811982473 PECOS PAC ID: 4183647027 Enrollment ID: I20060106000315 |
| Provider Name | Bernardo J Arias |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912992132 PECOS PAC ID: 4385626985 Enrollment ID: I20070421000045 |
| Provider Name | Elizabeth N Dosoretz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659565646 PECOS PAC ID: 8224112214 Enrollment ID: I20080229000124 |
| Provider Name | Staci F Knickrehm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588601132 PECOS PAC ID: 7113003898 Enrollment ID: I20080320000281 |
| Provider Name | Gail D Guillory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336122464 PECOS PAC ID: 9931273109 Enrollment ID: I20080922000274 |
| Provider Name | Laurie J Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952594848 PECOS PAC ID: 7517027303 Enrollment ID: I20081124000735 |
| Provider Name | Melissa T Fein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558419572 PECOS PAC ID: 8527120476 Enrollment ID: I20081231000134 |
| Provider Name | Christian L Romero |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881703817 PECOS PAC ID: 1951345032 Enrollment ID: I20090327000263 |
| Provider Name | Krista K Nieves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063644094 PECOS PAC ID: 3678611936 Enrollment ID: I20091107000041 |
| Provider Name | Sharon Arlene Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104098557 PECOS PAC ID: 3779613799 Enrollment ID: I20100617000221 |
| Provider Name | Sharon E Bloom |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750696720 PECOS PAC ID: 6901922913 Enrollment ID: I20100928000540 |
| Provider Name | Lynne S Bernay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568583979 PECOS PAC ID: 1456539741 Enrollment ID: I20110712000053 |
| Provider Name | Tracey Nicole Waite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053507020 PECOS PAC ID: 1557533767 Enrollment ID: I20111012000670 |
| Provider Name | Neil E Pauker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366452377 PECOS PAC ID: 0941206635 Enrollment ID: I20111207000378 |
| Provider Name | Jacqueline Bannister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194089227 PECOS PAC ID: 8527211994 Enrollment ID: I20130115000213 |
| Provider Name | Tamela M Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326461773 PECOS PAC ID: 2264661172 Enrollment ID: I20140218000822 |
| Provider Name | Dov Rapoport |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376971176 PECOS PAC ID: 3072421999 Enrollment ID: I20140407000431 |
| Provider Name | Carrie Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316210263 PECOS PAC ID: 6103080833 Enrollment ID: I20140918000574 |
| Provider Name | Tanika S Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871902130 PECOS PAC ID: 9931329166 Enrollment ID: I20141009002097 |
| Provider Name | Marie T Vancamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295123446 PECOS PAC ID: 7315266228 Enrollment ID: I20150427001923 |
| Provider Name | Adrienne R Eisner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144514605 PECOS PAC ID: 5395988950 Enrollment ID: I20150721003213 |
| Provider Name | Mary K Soucek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881954584 PECOS PAC ID: 3779892906 Enrollment ID: I20151028002950 |
| Provider Name | Stephanie Symonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457721540 PECOS PAC ID: 8123326253 Enrollment ID: I20160406000626 |
| Provider Name | Jan-paul Romero Mojica |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255776514 PECOS PAC ID: 9436449873 Enrollment ID: I20160526000904 |
| Provider Name | Delia Glisette Toledo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053514604 PECOS PAC ID: 1254512445 Enrollment ID: I20160527001779 |
| Provider Name | Matthew S Targoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184666513 PECOS PAC ID: 1254226434 Enrollment ID: I20160610000823 |
| Provider Name | Gayle M Popelka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306148754 PECOS PAC ID: 8527353564 Enrollment ID: I20160830000491 |
| Provider Name | Elizabeth Ann Hartlaub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518310598 PECOS PAC ID: 3678860160 Enrollment ID: I20160927002366 |
| Provider Name | Amanda Dittmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134572274 PECOS PAC ID: 6901187087 Enrollment ID: I20170104000070 |
| Provider Name | Tatiana Mijares-cantrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144762667 PECOS PAC ID: 2668754268 Enrollment ID: I20170113002523 |
| Provider Name | Noel L Helmic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447264858 PECOS PAC ID: 4486612645 Enrollment ID: I20170124002379 |
| Provider Name | Denise L Sanfilippo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497172605 PECOS PAC ID: 1658653738 Enrollment ID: I20170125001439 |
| Provider Name | Fabiola Anglade-pascal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326587908 PECOS PAC ID: 4789969981 Enrollment ID: I20170331000146 |
| Provider Name | Karen Lorena Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013453018 PECOS PAC ID: 5597032631 Enrollment ID: I20170522001129 |
| Provider Name | Jennifer K Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750764809 PECOS PAC ID: 3971891409 Enrollment ID: I20170603000289 |
| Provider Name | Judith Lenz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699099234 PECOS PAC ID: 8022380112 Enrollment ID: I20170824001477 |
| Provider Name | Barbara Ann Violette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174863351 PECOS PAC ID: 7810135019 Enrollment ID: I20171107003380 |
| Provider Name | Lisa Cloutier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164823332 PECOS PAC ID: 5597021725 Enrollment ID: I20180104001185 |
| Provider Name | Melanie Orben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669982377 PECOS PAC ID: 5496015950 Enrollment ID: I20180201002756 |
| Provider Name | Charity Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154823763 PECOS PAC ID: 9436411493 Enrollment ID: I20180403001018 |
| Provider Name | Deborahlin Huxtable |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477069516 PECOS PAC ID: 5799048765 Enrollment ID: I20180405000198 |
| Provider Name | Margaret Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437650017 PECOS PAC ID: 3173887171 Enrollment ID: I20180427000277 |
| Provider Name | Kristin Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215391610 PECOS PAC ID: 3678859816 Enrollment ID: I20180612003277 |
| Provider Name | Jennifer Simms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821587676 PECOS PAC ID: 3779831722 Enrollment ID: I20180807003172 |
| Provider Name | Christina Maria Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659866978 PECOS PAC ID: 0345590287 Enrollment ID: I20180913002385 |
| Provider Name | Jennifer Patton Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750876496 PECOS PAC ID: 1153675582 Enrollment ID: I20181121000301 |
| Provider Name | Shakhia Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851871024 PECOS PAC ID: 5193909547 Enrollment ID: I20181205003130 |
| Provider Name | Yanet Menendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720569031 PECOS PAC ID: 1557607041 Enrollment ID: I20190103001741 |
| Provider Name | Mary Anita Miller Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952879595 PECOS PAC ID: 0547506495 Enrollment ID: I20190114001588 |
| Provider Name | Robin A Huebner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295206902 PECOS PAC ID: 9537406319 Enrollment ID: I20190201000878 |
| Provider Name | Maryann E Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932624426 PECOS PAC ID: 3971869645 Enrollment ID: I20190206000780 |
| Provider Name | Sara A Aschebrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053877225 PECOS PAC ID: 8628317104 Enrollment ID: I20190227001945 |
| Provider Name | Mackenzie Labbe Althouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679032072 PECOS PAC ID: 7810238607 Enrollment ID: I20190403002994 |
| Provider Name | Roxanne V Kalch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043371768 PECOS PAC ID: 3577787985 Enrollment ID: I20190731000170 |
| Provider Name | Eric Jeffrey Raab |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184080509 PECOS PAC ID: 4284964081 Enrollment ID: I20190920001776 |
| Provider Name | John J Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043791866 PECOS PAC ID: 1355692633 Enrollment ID: I20190927000939 |
| Provider Name | Julie J Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801357066 PECOS PAC ID: 6608107628 Enrollment ID: I20191007000016 |
| Provider Name | Susan Gallen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720638570 PECOS PAC ID: 9133176555 Enrollment ID: I20191009001402 |
| Provider Name | Kiana R Gadson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376970491 PECOS PAC ID: 7719319250 Enrollment ID: I20191121000658 |
| Provider Name | Jeffery M Hutter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487299269 PECOS PAC ID: 3274967377 Enrollment ID: I20191226000481 |
| Provider Name | Elissa Rose Pasanello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720627094 PECOS PAC ID: 3971931973 Enrollment ID: I20200324003288 |
| Provider Name | Diana P Moorer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285151233 PECOS PAC ID: 9335578103 Enrollment ID: I20200330001442 |
| Provider Name | Sonica Sharma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346874955 PECOS PAC ID: 5597194399 Enrollment ID: I20200330003122 |
| Provider Name | Shawna Kemp Haley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497900799 PECOS PAC ID: 5698106243 Enrollment ID: I20200514001212 |
| Provider Name | Amanda Michelle Boroff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972139160 PECOS PAC ID: 6204257751 Enrollment ID: I20200609001105 |
| Provider Name | Marina Livis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376908558 PECOS PAC ID: 8729401096 Enrollment ID: I20200702001998 |
| Provider Name | Margaret Rose James |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1053574525 PECOS PAC ID: 5890119697 Enrollment ID: I20200727002830 |
| Provider Name | Jose Andro Cancio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245864164 PECOS PAC ID: 2466877717 Enrollment ID: I20200803002500 |
| Provider Name | Amanda M Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255671699 PECOS PAC ID: 3678999067 Enrollment ID: I20200817000776 |
| Provider Name | Camille D Markham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972114023 PECOS PAC ID: 1658790126 Enrollment ID: I20201001002986 |
| Provider Name | Ernesto Cristian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891343901 PECOS PAC ID: 3678983954 Enrollment ID: I20201028001864 |
| Provider Name | Asuncion O Kahn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558702415 PECOS PAC ID: 7911217773 Enrollment ID: I20201105002081 |
| Provider Name | Dylan Andrew Demars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619575818 PECOS PAC ID: 7416367974 Enrollment ID: I20201112000522 |
| Provider Name | Rachel Morgan Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831615111 PECOS PAC ID: 6002228384 Enrollment ID: I20201210000491 |
| Provider Name | Stephanie Mary Frost |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548582307 PECOS PAC ID: 6709298797 Enrollment ID: I20201216000949 |
| Provider Name | Mode M Hilaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073021630 PECOS PAC ID: 4284047820 Enrollment ID: I20201229000161 |
| Provider Name | Eileen Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730782178 PECOS PAC ID: 3173936713 Enrollment ID: I20201229000258 |
| Provider Name | Alexandre Pigeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780270157 PECOS PAC ID: 1052725819 Enrollment ID: I20210208000484 |
| Provider Name | Angela T. Kalem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265020002 PECOS PAC ID: 9931514965 Enrollment ID: I20210224001830 |
| Provider Name | Lorin Bullara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679949283 PECOS PAC ID: 8325454861 Enrollment ID: I20210309001243 |
| Provider Name | Latavia Marie Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760088272 PECOS PAC ID: 9739595737 Enrollment ID: I20210316002150 |
| Provider Name | Megan Fernandes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861943326 PECOS PAC ID: 7012324049 Enrollment ID: I20210318001202 |
| Provider Name | Luisa Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265751499 PECOS PAC ID: 3173932647 Enrollment ID: I20210513000728 |
| Provider Name | Deborah Dunivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639769342 PECOS PAC ID: 3577972835 Enrollment ID: I20210518000075 |
| Provider Name | Tatyana Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578063186 PECOS PAC ID: 7810397544 Enrollment ID: I20210616002631 |
| Provider Name | Gregg Steven Halverson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033776539 PECOS PAC ID: 6608277892 Enrollment ID: I20210625000111 |
| Provider Name | Lalencia L Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093380362 PECOS PAC ID: 4082016753 Enrollment ID: I20210719000423 |
| Provider Name | Shailendra Jain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174970883 PECOS PAC ID: 2365736030 Enrollment ID: I20210721003816 |
| Provider Name | Calvin Pham Tran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407376775 PECOS PAC ID: 9537564026 Enrollment ID: I20210820003006 |
| Provider Name | Kerri Anne Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073199725 PECOS PAC ID: 7618372020 Enrollment ID: I20210824001283 |
| Provider Name | Megan Marie Dunne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083287668 PECOS PAC ID: 7416352737 Enrollment ID: I20210825002126 |
| Provider Name | Lacey Marena Langston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528734258 PECOS PAC ID: 9830595974 Enrollment ID: I20210915000373 |
| Provider Name | Amanda Reef |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801306550 PECOS PAC ID: 7214360825 Enrollment ID: I20210916000773 |
| Provider Name | Mateland Lestery Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457964843 PECOS PAC ID: 3072901529 Enrollment ID: I20211102002403 |
| Provider Name | Jaydel D Rayne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033872122 PECOS PAC ID: 9931590460 Enrollment ID: I20211216002849 |
| Provider Name | Kathleen Nolan Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811184393 PECOS PAC ID: 7517350226 Enrollment ID: I20220201002250 |
| Provider Name | Briana Briggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407520489 PECOS PAC ID: 6103219795 Enrollment ID: I20220202003016 |
| Provider Name | Anna Marie Jorge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598207508 PECOS PAC ID: 2365836665 Enrollment ID: I20220302003049 |
| Provider Name | Sharlene Michelle Daley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669845889 PECOS PAC ID: 9830584192 Enrollment ID: I20220323001317 |
| Provider Name | Carly Geier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922761774 PECOS PAC ID: 4082000252 Enrollment ID: I20220415001470 |
| Provider Name | Tina Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982376968 PECOS PAC ID: 8628465291 Enrollment ID: I20220428002466 |
| Provider Name | Darcie Ann Lynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215506407 PECOS PAC ID: 5294112090 Enrollment ID: I20220517001887 |
| Provider Name | Lynn T Chau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760787972 PECOS PAC ID: 3870927270 Enrollment ID: I20220624002524 |
| Provider Name | Michelle Trevino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306507058 PECOS PAC ID: 2961881560 Enrollment ID: I20220627003730 |
| Provider Name | Gavin V Malcolm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811669062 PECOS PAC ID: 9436530607 Enrollment ID: I20220719002359 |
| Provider Name | Suzan L. Coger |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1316112519 PECOS PAC ID: 6103201066 Enrollment ID: I20220914001244 |
| Provider Name | Diana Lynne Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457089930 PECOS PAC ID: 5092190355 Enrollment ID: I20220922001922 |
| Provider Name | Ashleigh Depalma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962096024 PECOS PAC ID: 5799154464 Enrollment ID: I20221220001723 |
| Provider Name | Anita Dzelilovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396345716 PECOS PAC ID: 0941670657 Enrollment ID: I20221221000740 |
| Provider Name | Jennifer Lynn Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013510155 PECOS PAC ID: 4183095870 Enrollment ID: I20230117000086 |
| Provider Name | Roberto Santamaria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003481052 PECOS PAC ID: 5294106563 Enrollment ID: I20230124002043 |
| Provider Name | Angela Marie Mcneff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407089964 PECOS PAC ID: 2769646397 Enrollment ID: I20230307001607 |
| Provider Name | Collin Mcgrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447922521 PECOS PAC ID: 8426422460 Enrollment ID: I20230315000429 |
| Provider Name | Linda Nicholson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174922736 PECOS PAC ID: 9830451087 Enrollment ID: I20230323000615 |
| Provider Name | Angelica Bocian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992430409 PECOS PAC ID: 5193181824 Enrollment ID: I20230522003003 |
| Provider Name | Ashley Punches |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396255352 PECOS PAC ID: 5597027862 Enrollment ID: I20230617000193 |
| Provider Name | Jamie E White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558610279 PECOS PAC ID: 9638451115 Enrollment ID: I20230621000276 |
| Provider Name | Kevin Dalfonso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376140202 PECOS PAC ID: 2466810353 Enrollment ID: I20230626001287 |
| Provider Name | Stephanie Gravely |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609261403 PECOS PAC ID: 1456713346 Enrollment ID: I20230809001032 |
| Provider Name | Regina M Saglibene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841906971 PECOS PAC ID: 4385006162 Enrollment ID: I20230810001472 |
| Provider Name | Kristin Kerley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760527741 PECOS PAC ID: 2567659527 Enrollment ID: I20230810001476 |
| Provider Name | Brittany Nicole Mendo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750055620 PECOS PAC ID: 3678935426 Enrollment ID: I20230811000011 |
| Provider Name | Lisa Ann Butrymowicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790963601 PECOS PAC ID: 4183086812 Enrollment ID: I20230814000390 |
| Provider Name | Jaana Coogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417663949 PECOS PAC ID: 5597127175 Enrollment ID: I20230814002861 |
| Provider Name | Ariel Nicole Bracey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356838791 PECOS PAC ID: 5193188134 Enrollment ID: I20230824000589 |
| Provider Name | Tiffany P Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811622509 PECOS PAC ID: 8325401383 Enrollment ID: I20230824001237 |
| Provider Name | Shaun Aaron Fleniken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992450431 PECOS PAC ID: 5799148557 Enrollment ID: I20230825002052 |
| Provider Name | Natacha M Nicholas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265171367 PECOS PAC ID: 5193188985 Enrollment ID: I20230825003560 |
| Provider Name | Rose Tarsio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063995611 PECOS PAC ID: 3971841040 Enrollment ID: I20230828003616 |
| Provider Name | Marci Story |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619913019 PECOS PAC ID: 3375513377 Enrollment ID: I20230829000015 |
| Provider Name | Matthew Rocklage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851868202 PECOS PAC ID: 9436569605 Enrollment ID: I20230829000151 |
| Provider Name | Oscar Antonio Santos Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760117915 PECOS PAC ID: 2062875636 Enrollment ID: I20230830000169 |
| Provider Name | Donna Wrobel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477259976 PECOS PAC ID: 3476916727 Enrollment ID: I20230905000082 |
| Provider Name | Thea Brubaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982322293 PECOS PAC ID: 9739542002 Enrollment ID: I20230905000954 |
| Provider Name | Nazma Niles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023797719 PECOS PAC ID: 2769846450 Enrollment ID: I20230913003744 |
| Provider Name | Sita D'oyen Russ |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164134862 PECOS PAC ID: 2365896404 Enrollment ID: I20230925000070 |
| Provider Name | Kristen Melervey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871214452 PECOS PAC ID: 1850745910 Enrollment ID: I20230925000785 |
| Provider Name | Samantha Jane Garber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871284885 PECOS PAC ID: 1759735269 Enrollment ID: I20231002001464 |
| Provider Name | Johnny Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144937343 PECOS PAC ID: 8224482724 Enrollment ID: I20231003001371 |
| Provider Name | Elizabeth Britton Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689355133 PECOS PAC ID: 2466806872 Enrollment ID: I20231003002542 |
| Provider Name | Krista Shepard Seeds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194433441 PECOS PAC ID: 3274987623 Enrollment ID: I20231004000058 |
| Provider Name | Shara Lanecia Mcphall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003542549 PECOS PAC ID: 9133573520 Enrollment ID: I20231004001560 |
| Provider Name | M'lynn Renee Mckibben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427779198 PECOS PAC ID: 2860846250 Enrollment ID: I20231004001575 |
| Provider Name | Katherine Woolard Suter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346956331 PECOS PAC ID: 9436504826 Enrollment ID: I20231004001838 |
| Provider Name | Margaret Ann Watts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194296699 PECOS PAC ID: 3779938121 Enrollment ID: I20231005000186 |
| Provider Name | Jennifer Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447944954 PECOS PAC ID: 7911352885 Enrollment ID: I20231012001237 |
| Provider Name | Alyssia Niobe Boldin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366048332 PECOS PAC ID: 7416302328 Enrollment ID: I20231012002947 |
| Provider Name | Jennifer Zaccaria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467136242 PECOS PAC ID: 9739534595 Enrollment ID: I20231013001453 |
| Provider Name | Nicole Bogue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902590847 PECOS PAC ID: 8123473998 Enrollment ID: I20231013002352 |
| Provider Name | Michelle Sterban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164109799 PECOS PAC ID: 3678928447 Enrollment ID: I20231013002366 |
| Provider Name | Susan Ruth Kimper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619602828 PECOS PAC ID: 4789039587 Enrollment ID: I20231014000048 |
| Provider Name | Deborah Gail Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376255489 PECOS PAC ID: 5193170835 Enrollment ID: I20231016001489 |
| Provider Name | Camryn Sara Sartory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083367098 PECOS PAC ID: 3274989736 Enrollment ID: I20231019003684 |
| Provider Name | Anne-christine Surin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902302243 PECOS PAC ID: 7416303573 Enrollment ID: I20231025002053 |
| Provider Name | Saintania Amilcar Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972255917 PECOS PAC ID: 9436505500 Enrollment ID: I20231025002443 |
| Provider Name | Rachel Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558019802 PECOS PAC ID: 9638525405 Enrollment ID: I20231031000737 |
| Provider Name | Natalie Kutlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174139513 PECOS PAC ID: 1254787963 Enrollment ID: I20231031002712 |
| Provider Name | Shirah Lynn Hoffman |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1114067311 PECOS PAC ID: 8820444540 Enrollment ID: I20231031003438 |
| Provider Name | Owen Wesley Kelchner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770365173 PECOS PAC ID: 7517314115 Enrollment ID: I20231102003887 |
| Provider Name | Caprice Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386307205 PECOS PAC ID: 0648627729 Enrollment ID: I20231110001628 |
| Provider Name | Cheryl Barry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558899773 PECOS PAC ID: 6406203371 Enrollment ID: I20231114003743 |
| Provider Name | Jose Luis Gonzalez-roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063187128 PECOS PAC ID: 7214384098 Enrollment ID: I20231116000404 |
| Provider Name | Dustin Ernest Baetz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174192173 PECOS PAC ID: 7911354634 Enrollment ID: I20231116002605 |
| Provider Name | Ayanna Sheree Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134796071 PECOS PAC ID: 1456708148 Enrollment ID: I20231117001869 |
| Provider Name | Alan Crandall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871949412 PECOS PAC ID: 4981052669 Enrollment ID: I20231120001533 |
| Provider Name | Ebony Nicole Bonner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245494459 PECOS PAC ID: 1254789837 Enrollment ID: I20231120001989 |
| Provider Name | Hillary Nicole Cromartie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447880885 PECOS PAC ID: 5991153587 Enrollment ID: I20231120002460 |
| Provider Name | Amy I Hale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376011023 PECOS PAC ID: 1850749458 Enrollment ID: I20231120003260 |
| Provider Name | John Daley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194299511 PECOS PAC ID: 8426406034 Enrollment ID: I20231120003579 |
| Provider Name | Gabrielle Clement |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447753892 PECOS PAC ID: 8921456542 Enrollment ID: I20231121000101 |
| Provider Name | Sharon Clime |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871108118 PECOS PAC ID: 7618325234 Enrollment ID: I20231121000288 |
| Provider Name | Carla P Leslie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649673419 PECOS PAC ID: 1850749482 Enrollment ID: I20231121000547 |
| Provider Name | Morgan Z London |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306971783 PECOS PAC ID: 0648628271 Enrollment ID: I20231121000687 |
| Provider Name | Jenai Hicks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851916811 PECOS PAC ID: 9638527260 Enrollment ID: I20231121000726 |
| Provider Name | Susan Longo Gurfein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306135595 PECOS PAC ID: 1254789886 Enrollment ID: I20231121000809 |
| Provider Name | Claudia Mora |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1932891736 PECOS PAC ID: 4789032350 Enrollment ID: I20231121002344 |
| Provider Name | Stacy M Hernandez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639781271 PECOS PAC ID: 6305294893 Enrollment ID: I20231121003740 |
| Provider Name | Hannah Marie Thielman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932749884 PECOS PAC ID: 4587012018 Enrollment ID: I20231122000931 |
| Provider Name | Maureen Muckle Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831280601 PECOS PAC ID: 1658798111 Enrollment ID: I20231122001214 |
| Provider Name | Megan Girard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063807162 PECOS PAC ID: 6406204866 Enrollment ID: I20231122002460 |
| Provider Name | Nichol Kobler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548845225 PECOS PAC ID: 5294183687 Enrollment ID: I20231123000034 |
| Provider Name | Katrice Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780925784 PECOS PAC ID: 0749638146 Enrollment ID: I20231124000359 |
| Provider Name | Krystin Carlotti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285348052 PECOS PAC ID: 9739537135 Enrollment ID: I20231124000412 |
| Provider Name | Tesia Stokes Jean |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730778002 PECOS PAC ID: 2163870569 Enrollment ID: I20231125000135 |
| Provider Name | Luis Navarrete |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801336763 PECOS PAC ID: 0941658355 Enrollment ID: I20231125000343 |
| Provider Name | Melinda Sue Gillespie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932705027 PECOS PAC ID: 8022466432 Enrollment ID: I20231126000027 |
| Provider Name | Kristina Lynn Mathey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962031492 PECOS PAC ID: 5395193700 Enrollment ID: I20231126000047 |
| Provider Name | Melanie Milano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295342608 PECOS PAC ID: 9830547249 Enrollment ID: I20231126000062 |
| Provider Name | Erin Rollins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336731488 PECOS PAC ID: 3476901885 Enrollment ID: I20231126000078 |
| Provider Name | Anslie Merle Stark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861834319 PECOS PAC ID: 9739537168 Enrollment ID: I20231127000695 |
| Provider Name | Amanda Youngsman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821460825 PECOS PAC ID: 6204284649 Enrollment ID: I20231127001073 |
| Provider Name | Andrew R Penn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275161341 PECOS PAC ID: 9537517974 Enrollment ID: I20231127001179 |
| Provider Name | Gita M Patel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265744031 PECOS PAC ID: 0143678599 Enrollment ID: I20231127001344 |
| Provider Name | Jordan Warta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457013740 PECOS PAC ID: 9830547181 Enrollment ID: I20231127001913 |
| Provider Name | Lauren Whitehurst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023669322 PECOS PAC ID: 0749638005 Enrollment ID: I20231127002228 |
| Provider Name | Larisa Vivolo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265116370 PECOS PAC ID: 8426406711 Enrollment ID: I20231127003448 |
| Provider Name | Charmaine Rosemarie Wolfe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467976597 PECOS PAC ID: 5698123925 Enrollment ID: I20231128001366 |
| Provider Name | Mary Tero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063831840 PECOS PAC ID: 1153779491 Enrollment ID: I20231128001697 |
| Provider Name | Yaneris Lopez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548923287 PECOS PAC ID: 9032567375 Enrollment ID: I20231128001787 |
| Provider Name | Matthew Dewayne Murrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528660230 PECOS PAC ID: 0941658280 Enrollment ID: I20231128001790 |
| Provider Name | Marylou Ugo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912253147 PECOS PAC ID: 8426406661 Enrollment ID: I20231128002086 |
| Provider Name | Mary Lou Docksey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588062822 PECOS PAC ID: 4688022825 Enrollment ID: I20231128002178 |
| Provider Name | Roxana Duren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336538024 PECOS PAC ID: 1759699556 Enrollment ID: I20231128002342 |
| Provider Name | Stephanie Ann Fretwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619392982 PECOS PAC ID: 8123476306 Enrollment ID: I20231129000122 |
| Provider Name | Elaine Esplin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679094734 PECOS PAC ID: 3577911767 Enrollment ID: I20231129000193 |
| Provider Name | Benoit Duhamel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750980322 PECOS PAC ID: 7719335900 Enrollment ID: I20231129000329 |
| Provider Name | Lissette Muniz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124325840 PECOS PAC ID: 4789032970 Enrollment ID: I20231129000476 |
| Provider Name | Wayne Meddock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033126875 PECOS PAC ID: 4688944028 Enrollment ID: I20231129001578 |
| Provider Name | Alexander Conrad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952759342 PECOS PAC ID: 1456709583 Enrollment ID: I20231129002432 |
| Provider Name | Laura E Elgin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588255442 PECOS PAC ID: 9234587304 Enrollment ID: I20231129003930 |
| Provider Name | John Maguire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366839607 PECOS PAC ID: 5698123768 Enrollment ID: I20231129003943 |
| Provider Name | Lukas Neumann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013695394 PECOS PAC ID: 3779931845 Enrollment ID: I20231129003974 |
| Provider Name | John Joseph Pimentel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912474909 PECOS PAC ID: 5890143820 Enrollment ID: I20231130002491 |
| Provider Name | Guillermo Diaz-cruz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134671365 PECOS PAC ID: 3870941701 Enrollment ID: I20231201002975 |
| Provider Name | Stanton Hugger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881053437 PECOS PAC ID: 4880042753 Enrollment ID: I20231204000675 |
| Provider Name | Chelsea Dean |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134543887 PECOS PAC ID: 9133577018 Enrollment ID: I20231204000751 |
| Provider Name | Sandra Ibelka Mustelier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174920649 PECOS PAC ID: 7618325598 Enrollment ID: I20231204001031 |
| Provider Name | Maria Dewar Rivera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689780652 PECOS PAC ID: 4385092287 Enrollment ID: I20231204001751 |
| Provider Name | Alishia Albritton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639943855 PECOS PAC ID: 2062860885 Enrollment ID: I20231204002884 |
| Provider Name | Cindy Stellon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952779308 PECOS PAC ID: 5597113324 Enrollment ID: I20231204003380 |
| Provider Name | Laurie Heller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376840272 PECOS PAC ID: 7719335553 Enrollment ID: I20231204003687 |
| Provider Name | Crystal Raullerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609467620 PECOS PAC ID: 0840648614 Enrollment ID: I20231205001001 |
| Provider Name | Isabella Alcantara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669247474 PECOS PAC ID: 5395194930 Enrollment ID: I20231208000316 |
| Provider Name | Courtney Alexis Parker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053037135 PECOS PAC ID: 5092164566 Enrollment ID: I20231208001549 |
| Provider Name | Daisy Alberto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508241225 PECOS PAC ID: 3476902909 Enrollment ID: I20231209000634 |
| Provider Name | Debra Anne King-ferro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700215597 PECOS PAC ID: 2062861503 Enrollment ID: I20231210000075 |
| Provider Name | Rabia Abid |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588443816 PECOS PAC ID: 4688023120 Enrollment ID: I20231211000043 |
| Provider Name | Cali Kervin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467196014 PECOS PAC ID: 3173972569 Enrollment ID: I20231211001990 |
| Provider Name | Iblin Penagos-chinchilla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457827727 PECOS PAC ID: 0345699690 Enrollment ID: I20231212000966 |
| Provider Name | Amanda Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932627619 PECOS PAC ID: 3779932033 Enrollment ID: I20231212001463 |
| Provider Name | Carla Sprewell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477147932 PECOS PAC ID: 6204285562 Enrollment ID: I20231212001555 |
| Provider Name | Carolyn Pereira |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588254551 PECOS PAC ID: 4981053261 Enrollment ID: I20231212002184 |
| Provider Name | Susan George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760176515 PECOS PAC ID: 0345699575 Enrollment ID: I20231212004273 |
| Provider Name | Edward John Samaro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497764203 PECOS PAC ID: 8325497563 Enrollment ID: I20231213000426 |
| Provider Name | Loretta Ann Player |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336791813 PECOS PAC ID: 2860841053 Enrollment ID: I20231213002190 |
| Provider Name | Savannah Kay-lee Klee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720855901 PECOS PAC ID: 4082063185 Enrollment ID: I20231214003071 |
| Provider Name | Cheryl Ann Champagne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396411062 PECOS PAC ID: 7618326638 Enrollment ID: I20231215000038 |
| Provider Name | Nicolas Rodriquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225802838 PECOS PAC ID: 6800245705 Enrollment ID: I20231216000214 |
| Provider Name | Shanna Duffy |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114793098 PECOS PAC ID: 9335598226 Enrollment ID: I20231218003540 |
| Provider Name | Jacqueline Brice Maccarthy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639541527 PECOS PAC ID: 8022468966 Enrollment ID: I20231219001346 |
| Provider Name | Samantha Gabriel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891325056 PECOS PAC ID: 7810347564 Enrollment ID: I20231221002116 |
| Provider Name | Lauren Whitworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275229171 PECOS PAC ID: 4587014188 Enrollment ID: I20231222000525 |
| Provider Name | Adam Sanders |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912457268 PECOS PAC ID: 3072963412 Enrollment ID: I20231227000649 |
| Provider Name | Daniella Elzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386421949 PECOS PAC ID: 6103277116 Enrollment ID: I20240103004284 |
| Provider Name | Lindsay A Ensell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942082847 PECOS PAC ID: 5092166025 Enrollment ID: I20240103004864 |
| Provider Name | Aisha Vielot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275163834 PECOS PAC ID: 5698127629 Enrollment ID: I20240116001422 |
| Provider Name | Jamie Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376315101 PECOS PAC ID: 5496108623 Enrollment ID: I20240124002310 |
| Provider Name | Zoe Skowronski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508627852 PECOS PAC ID: 3476996653 Enrollment ID: I20240205001628 |
| Provider Name | Samuel Steven Marcus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336831981 PECOS PAC ID: 2365886900 Enrollment ID: I20240222000228 |
| Provider Name | Jennifer Deneus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306566856 PECOS PAC ID: 0446696561 Enrollment ID: I20240312002267 |
| Provider Name | Dawn Allison Nichols |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134626401 PECOS PAC ID: 1456797356 Enrollment ID: I20240314000798 |
| Provider Name | Renata Fernandes Piper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023727989 PECOS PAC ID: 7618313495 Enrollment ID: I20240315000032 |
| Provider Name | Enel Vildor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457064933 PECOS PAC ID: 6901242619 Enrollment ID: I20240315001139 |
Fort Myers Psychology, Pa Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 12791 World Plaza Ln Bldg 89, Fort Myers, FL 33907 Phone: 239-829-5494 Fax: 239-645-4777 | |
D J Koehn Consulting Services Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8359 Beacon Blvd Ste 301, Fort Myers, FL 33907 Phone: 571-309-7993 Fax: 800-387-5701 | |
Neuropsychiatric Research Center Of Southwest Florida Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14271 Metropolis Ave, Suite A, Fort Myers, FL 33912 Phone: 239-939-7777 Fax: 239-936-0036 | |
Hope Community Wellness Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6238 Presidential Ct # Crt 7/8, Fort Myers, FL 33919 Phone: 863-233-9190 | |
Health Planning Council Of Southwest Florida, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8961 Daniels Center Dr Ste 401, Fort Myers, FL 33912 Phone: 239-433-6700 | |
Nest Academy & Therapy Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4755 Summerlin Rd Ste 4, Fort Myers, FL 33919 Phone: 786-382-5779 | |
Gables Rehab Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3049 Cleveland Ave Ste 145, Fort Myers, FL 33901 Phone: 786-641-1312 |