| Heritage Mental Health Clinic, Llc | |
|
2110 Sw Belle Ave Ste B Topeka KS 66614-1773 | |
| (785) 272-5566 | |
| (785) 272-5967 |
| Full Name | Heritage Mental Health Clinic, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2110 Sw Belle Ave Ste B, Topeka, Kansas |
| Authorized Official Name and Position | Dora Clark (BILLING MANAGER) |
| Authorized Official Contact | 7852725566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Mental Health Clinic, Llc 2110 Sw Belle Ave Ste B Topeka KS 66614-1773 Ph: (785) 272-5566 | Heritage Mental Health Clinic, Llc 2110 Sw Belle Ave Ste B Topeka KS 66614-1773 Ph: (785) 272-5566 |
| NPI Number | 1487650842 |
|---|---|
| Provider Enumeration Date | 06/21/2005 |
| Last Update Date | 06/24/2020 |
| Certification Date | 06/24/2020 |
| Medicare PECOS PAC ID | 6901874148 |
|---|---|
| Medicare Enrollment ID | O20040924000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487650842 | NPI | - | NPPES |
| Provider Name | David S Blakely |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518075621 PECOS PAC ID: 9436110251 Enrollment ID: I20110830000766 |
| Provider Name | Marceil D Bauman-bork |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225146319 PECOS PAC ID: 6608837422 Enrollment ID: I20110830000776 |
| Provider Name | Mary Ann Abbott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013989458 PECOS PAC ID: 3072637388 Enrollment ID: I20111104000126 |
| Provider Name | Michelle Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497866891 PECOS PAC ID: 2365792660 Enrollment ID: I20180907000666 |
| Provider Name | Katherine G Weyrens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366599847 PECOS PAC ID: 2062830730 Enrollment ID: I20200911001179 |
| Provider Name | Janna M Walpole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023414570 PECOS PAC ID: 8325459894 Enrollment ID: I20201204002091 |
| Provider Name | Neil F Buono |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659692416 PECOS PAC ID: 0244579464 Enrollment ID: I20231207002219 |
| Provider Name | Laura B Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851024319 PECOS PAC ID: 6204271943 Enrollment ID: I20240304002428 |
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