| Geriatric Psychiatric Services Pllc | |
|
1715 Indian Wood Cir Ste 200 Maumee OH 43537-4055 | |
| (877) 906-9699 | |
| Not Available |
| Full Name | Geriatric Psychiatric Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1715 Indian Wood Cir Ste 200, Maumee, Ohio |
| Authorized Official Name and Position | Robert A Clemente (MANAGER) |
| Authorized Official Contact | 5866208100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Psychiatric Services Pllc 28800 Ryan Rd Suite 320 Warren MI 48092-4269 Ph: (586) 620-8100 | Geriatric Psychiatric Services Pllc 1715 Indian Wood Cir Ste 200 Maumee OH 43537-4055 Ph: (877) 906-9699 |
| NPI Number | 1467492173 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6204837388 |
|---|---|
| Medicare Enrollment ID | O20101028000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467492173 | NPI | - | NPPES |
| 260F340040 | Other | MI | BCBS PHYSICIAN GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0700X | Psychologist - Adult Development & Aging | (* (Not Available)) | Primary |
| Provider Name | Michael J Kerrigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982689089 PECOS PAC ID: 2466430392 Enrollment ID: I20040708000726 |
| Provider Name | Ronald D Gordineer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700018785 PECOS PAC ID: 9537212253 Enrollment ID: I20090728000820 |
| Provider Name | Michelle L Drain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992093728 PECOS PAC ID: 3072782846 Enrollment ID: I20110811000692 |
| Provider Name | Kenneth Adler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619072659 PECOS PAC ID: 2769498872 Enrollment ID: I20120202000948 |
| Provider Name | Sharon R Schlater |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558426957 PECOS PAC ID: 3779743984 Enrollment ID: I20120326000737 |
| Provider Name | Lisa A Caffee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548706807 PECOS PAC ID: 4082996921 Enrollment ID: I20170208002837 |
| Provider Name | Julie A Leatherman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639580160 PECOS PAC ID: 7517242076 Enrollment ID: I20170323001681 |
| Provider Name | Stacie L Hertzsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851824916 PECOS PAC ID: 1557648557 Enrollment ID: I20170428001813 |
| Provider Name | Kristy M Byerly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386024487 PECOS PAC ID: 4587962766 Enrollment ID: I20170817003024 |
| Provider Name | Robert Lacoste |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689618076 PECOS PAC ID: 8921996786 Enrollment ID: I20171016002949 |
| Provider Name | Deborah A Rich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104943265 PECOS PAC ID: 0648222430 Enrollment ID: I20180131001553 |
| Provider Name | Shudonica Garlington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841434453 PECOS PAC ID: 1951666403 Enrollment ID: I20180604001317 |
| Provider Name | Keith A Christie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063607182 PECOS PAC ID: 8527232172 Enrollment ID: I20190117001877 |
| Provider Name | Anjanette Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427543198 PECOS PAC ID: 3375974025 Enrollment ID: I20200512003688 |
| Provider Name | Cassandra J Kaiser-barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043881683 PECOS PAC ID: 0042612707 Enrollment ID: I20210716002738 |
| Provider Name | Nyla B Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669060083 PECOS PAC ID: 9739585175 Enrollment ID: I20210928003617 |
| Provider Name | Katherine Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821661257 PECOS PAC ID: 1850778846 Enrollment ID: I20220512001661 |
| Provider Name | Renee E Craft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205302288 PECOS PAC ID: 2567834575 Enrollment ID: I20230220002049 |
| Provider Name | Faith Wawira Obonyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801513692 PECOS PAC ID: 1759756281 Enrollment ID: I20230413002660 |
| Provider Name | Reyna S Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114621307 PECOS PAC ID: 8628434628 Enrollment ID: I20230517002256 |
| Provider Name | Angela Jean Napierala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952017352 PECOS PAC ID: 7012374259 Enrollment ID: I20230605000445 |
| Provider Name | Navjyot K Binning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649962853 PECOS PAC ID: 0143680991 Enrollment ID: I20230712002774 |
| Provider Name | Richard Lee Vaughn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801843818 PECOS PAC ID: 7719998012 Enrollment ID: I20231113002623 |
| Provider Name | Leslie Witherell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013967702 PECOS PAC ID: 9931207099 Enrollment ID: I20231201002405 |
| Provider Name | Brittany Pendleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780462150 PECOS PAC ID: 6800248915 Enrollment ID: I20240113000352 |
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