| Lifestance Health | |
|
122 Gateway Blvd Ste C Mooresville NC 28117-5544 | |
| (704) 360-3637 | |
| Not Available |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Psychologist |
| Location | 122 Gateway Blvd Ste C, Mooresville, North Carolina |
| Authorized Official Name and Position | Ryan Pardo (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 2063991493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health Po Box 4962 Mooresville NC 28117-4962 | Lifestance Health 122 Gateway Blvd Ste C Mooresville NC 28117-5544 Ph: (704) 360-3637 |
| NPI Number | 1447760871 |
|---|---|
| Provider Enumeration Date | 10/12/2017 |
| Last Update Date | 05/21/2025 |
| Certification Date | 05/21/2025 |
| Medicare PECOS PAC ID | 8022341494 |
|---|---|
| Medicare Enrollment ID | O20190618000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447760871 | NPI | - | NPPES |
| Provider Name | Denise W Logan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154693877 PECOS PAC ID: 2365422953 Enrollment ID: I20040723000473 |
| Provider Name | Pamela Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588655666 PECOS PAC ID: 2163436072 Enrollment ID: I20060131000316 |
| Provider Name | Barry C Weed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568534485 PECOS PAC ID: 7113103680 Enrollment ID: I20110517000909 |
| Provider Name | Christopher Fox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336340835 PECOS PAC ID: 1759301302 Enrollment ID: I20111128000193 |
| Provider Name | Shukairo Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659666444 PECOS PAC ID: 8921241522 Enrollment ID: I20130829000692 |
| Provider Name | Susan Curtis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093776320 PECOS PAC ID: 6305864299 Enrollment ID: I20130910000688 |
| Provider Name | Josephine Ochulo-chinwe Onuoha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881033678 PECOS PAC ID: 1254555295 Enrollment ID: I20140613001783 |
| Provider Name | Megan B Comer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689092587 PECOS PAC ID: 9638395072 Enrollment ID: I20140722000015 |
| Provider Name | Jennifer Parker Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013245745 PECOS PAC ID: 0648497479 Enrollment ID: I20140818002778 |
| Provider Name | Catherine a Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619050713 PECOS PAC ID: 2567650815 Enrollment ID: I20151229001834 |
| Provider Name | Elisabeth Hargrove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457408866 PECOS PAC ID: 0840583647 Enrollment ID: I20160801000279 |
| Provider Name | Safiyyah Nafeesah Feaster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518288752 PECOS PAC ID: 8628364478 Enrollment ID: I20160906000771 |
| Provider Name | Donna N Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619353612 PECOS PAC ID: 0042593956 Enrollment ID: I20170220000001 |
| Provider Name | Sue Ann Bingham Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013054105 PECOS PAC ID: 9931465069 Enrollment ID: I20171107000005 |
| Provider Name | Adrienne Nicole Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528371853 PECOS PAC ID: 5597021972 Enrollment ID: I20171117002911 |
| Provider Name | Courtney S Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437401023 PECOS PAC ID: 0244597987 Enrollment ID: I20171205000994 |
| Provider Name | Heart Song Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528204179 PECOS PAC ID: 3971864133 Enrollment ID: I20180302002042 |
| Provider Name | Bret Allen Guidry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588634554 PECOS PAC ID: 5496018178 Enrollment ID: I20180410003241 |
| Provider Name | Sugaree G Ganzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245749126 PECOS PAC ID: 5193070787 Enrollment ID: I20180622001387 |
| Provider Name | Mindi Marie Perry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306176599 PECOS PAC ID: 6800077835 Enrollment ID: I20180625000917 |
| Provider Name | Colleen Baldrige |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619464906 PECOS PAC ID: 0143576900 Enrollment ID: I20180709002871 |
| Provider Name | Sarah Larson Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205226685 PECOS PAC ID: 5193076370 Enrollment ID: I20180927000953 |
| Provider Name | Shea Spampneto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902274533 PECOS PAC ID: 4385986975 Enrollment ID: I20190501000794 |
| Provider Name | Nicole Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649684044 PECOS PAC ID: 6002240587 Enrollment ID: I20191217001841 |
| Provider Name | Robert Bruce Risavi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144530940 PECOS PAC ID: 4082048319 Enrollment ID: I20191219002151 |
| Provider Name | Kristina Claire Borus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487297636 PECOS PAC ID: 9537593108 Enrollment ID: I20200107003227 |
| Provider Name | Laquetta Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376196998 PECOS PAC ID: 1557799889 Enrollment ID: I20200319000862 |
| Provider Name | Catelyn Vanauken Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356977623 PECOS PAC ID: 6406286384 Enrollment ID: I20200416000950 |
| Provider Name | Altonette M Coney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093340317 PECOS PAC ID: 7719317007 Enrollment ID: I20200429001981 |
| Provider Name | Pamela Feuerstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639788953 PECOS PAC ID: 8527485796 Enrollment ID: I20200902001699 |
| Provider Name | Robert L Bauer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437165669 PECOS PAC ID: 3971536194 Enrollment ID: I20200910002842 |
| Provider Name | Kenya Windley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821483876 PECOS PAC ID: 3476963356 Enrollment ID: I20201104000719 |
| Provider Name | John Melbourne Mcgraw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043249386 PECOS PAC ID: 5597834507 Enrollment ID: I20201230001252 |
| Provider Name | Sakina Alston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073107751 PECOS PAC ID: 2062811920 Enrollment ID: I20210525002997 |
| Provider Name | Pratima Dahal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144801374 PECOS PAC ID: 2163823410 Enrollment ID: I20210624002205 |
| Provider Name | Wayne Alan Alston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376805762 PECOS PAC ID: 2365834322 Enrollment ID: I20220125000737 |
| Provider Name | Taquita Shanee Milner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891355970 PECOS PAC ID: 2769876333 Enrollment ID: I20220224000579 |
| Provider Name | Clarissa Anita Elmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710523196 PECOS PAC ID: 3678967635 Enrollment ID: I20220308002276 |
| Provider Name | Melinda Padmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861860033 PECOS PAC ID: 2365839446 Enrollment ID: I20220419002013 |
| Provider Name | Tyler N Edgerton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851904999 PECOS PAC ID: 5092192609 Enrollment ID: I20220520001862 |
| Provider Name | Lillian Lashae Outlaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760880959 PECOS PAC ID: 5193069615 Enrollment ID: I20220627001105 |
| Provider Name | Patricia Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760009005 PECOS PAC ID: 0840619441 Enrollment ID: I20220727000545 |
| Provider Name | Nicholas Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649928698 PECOS PAC ID: 8325421241 Enrollment ID: I20220810001163 |
| Provider Name | Victoria a Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174268981 PECOS PAC ID: 8325421753 Enrollment ID: I20220818000814 |
| Provider Name | Claris Livingstone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992321962 PECOS PAC ID: 4688092661 Enrollment ID: I20220831003475 |
| Provider Name | Alexandra Judith Lagunas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215459524 PECOS PAC ID: 0244614790 Enrollment ID: I20220831003577 |
| Provider Name | Tiffany Lindsay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821769894 PECOS PAC ID: 6002290566 Enrollment ID: I20220831003865 |
| Provider Name | Robert Anthony Townsend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699317198 PECOS PAC ID: 6406232453 Enrollment ID: I20220929000339 |
| Provider Name | Kelly Lynn Callahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629794755 PECOS PAC ID: 8123496486 Enrollment ID: I20221118000080 |
| Provider Name | Sia Komba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518587807 PECOS PAC ID: 1456757194 Enrollment ID: I20221121003345 |
| Provider Name | Lucy Seagraves Magda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952077224 PECOS PAC ID: 7315316478 Enrollment ID: I20221212001935 |
| Provider Name | Amanda Serena Read |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033751896 PECOS PAC ID: 3072983469 Enrollment ID: I20221229000796 |
| Provider Name | Melisa Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386388932 PECOS PAC ID: 5597136820 Enrollment ID: I20230125001436 |
| Provider Name | Daniel Lee Fish |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609223791 PECOS PAC ID: 7113219015 Enrollment ID: I20230322003052 |
| Provider Name | Lori F Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841593845 PECOS PAC ID: 5193190064 Enrollment ID: I20230406000348 |
| Provider Name | Ananda Hodgson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689346454 PECOS PAC ID: 0648636878 Enrollment ID: I20230515000661 |
| Provider Name | Cassie Paige Levigne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114623030 PECOS PAC ID: 5496111528 Enrollment ID: I20230516002309 |
| Provider Name | Kim Sylvia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912620600 PECOS PAC ID: 9032583604 Enrollment ID: I20230707003484 |
| Provider Name | Carly Alyse Wooten |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194373951 PECOS PAC ID: 7012371271 Enrollment ID: I20230907000607 |
| Provider Name | Tia Janee Glaspie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508562349 PECOS PAC ID: 1052765088 Enrollment ID: I20230926000239 |
| Provider Name | Laura Elaine Haynes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336822717 PECOS PAC ID: 7911354527 Enrollment ID: I20231103000137 |
| Provider Name | Kirk Dillon Mochrie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821647389 PECOS PAC ID: 7517315534 Enrollment ID: I20231130001997 |
| Provider Name | Jennifer Mengel Hundt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417516337 PECOS PAC ID: 3375992423 Enrollment ID: I20231214000660 |
| Provider Name | Kellie Marie Shuford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831666494 PECOS PAC ID: 1254781669 Enrollment ID: I20231228000047 |
| Provider Name | Chelsey Diane Mcrorie Bartholet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457600983 PECOS PAC ID: 8325498652 Enrollment ID: I20231228000897 |
| Provider Name | Ashley Elizabeth Bagwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972998938 PECOS PAC ID: 0244680478 Enrollment ID: I20231229000810 |
| Provider Name | Kristen Nash Bumgarner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689204307 PECOS PAC ID: 0648620849 Enrollment ID: I20240101000363 |
| Provider Name | Stephen Paul Mcalister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285979104 PECOS PAC ID: 5092166082 Enrollment ID: I20240103003568 |
| Provider Name | Anna D Gross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851881569 PECOS PAC ID: 2860843547 Enrollment ID: I20240106000531 |
| Provider Name | Andrea Weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780148908 PECOS PAC ID: 2062863798 Enrollment ID: I20240108003262 |
| Provider Name | Latisha Chambers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518670124 PECOS PAC ID: 1951752575 Enrollment ID: I20240109000266 |
| Provider Name | Melissa Morgan Cobbs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932494721 PECOS PAC ID: 0446601884 Enrollment ID: I20240110000447 |
| Provider Name | Tiffany Corbett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942738968 PECOS PAC ID: 7618328097 Enrollment ID: I20240110002141 |
| Provider Name | Melissa Lynn Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669808101 PECOS PAC ID: 4385095504 Enrollment ID: I20240111002737 |
| Provider Name | Larry Jones Dagenhart |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558989616 PECOS PAC ID: 9234580424 Enrollment ID: I20240112000103 |
| Provider Name | Meghann Goddard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073104212 PECOS PAC ID: 7810348000 Enrollment ID: I20240112000310 |
| Provider Name | Heather Lee Herrig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235511023 PECOS PAC ID: 3678924875 Enrollment ID: I20240112000519 |
| Provider Name | Helen Lynn Dula |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265956080 PECOS PAC ID: 3173974375 Enrollment ID: I20240112000660 |
| Provider Name | Stephanie L Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780187831 PECOS PAC ID: 7810349842 Enrollment ID: I20240116001294 |
| Provider Name | Jenna Sara Murphy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942951686 PECOS PAC ID: 5092167031 Enrollment ID: I20240116001659 |
| Provider Name | Asia Natashia Fairley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407257504 PECOS PAC ID: 5991157885 Enrollment ID: I20240116003404 |
| Provider Name | Katherine Ruth Dickerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780816603 PECOS PAC ID: 5698127413 Enrollment ID: I20240117003507 |
| Provider Name | Courtney B Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154894665 PECOS PAC ID: 0143672899 Enrollment ID: I20240117004745 |
| Provider Name | Cynthia Patrice Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093269631 PECOS PAC ID: 6305298035 Enrollment ID: I20240118002444 |
| Provider Name | Arley Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174855852 PECOS PAC ID: 9133571631 Enrollment ID: I20240119004009 |
| Provider Name | Brooke Lachance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639655566 PECOS PAC ID: 0648622969 Enrollment ID: I20240122004395 |
| Provider Name | Paul a Louis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407409691 PECOS PAC ID: 6608228937 Enrollment ID: I20240122004593 |
| Provider Name | Michelle M Hawbaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710079629 PECOS PAC ID: 3375992878 Enrollment ID: I20240124003246 |
| Provider Name | Sarah Barkley Sullivan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730721002 PECOS PAC ID: 8820441835 Enrollment ID: I20240125003941 |
| Provider Name | Barbara Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376868653 PECOS PAC ID: 0143673178 Enrollment ID: I20240126000114 |
| Provider Name | Brianne Chauvigne Reedy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316442908 PECOS PAC ID: 3678926615 Enrollment ID: I20240126000222 |
| Provider Name | Angela Robin Wyatt Wooten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386039428 PECOS PAC ID: 3072966878 Enrollment ID: I20240129001681 |
| Provider Name | Megan Ann Sullivan Slingerland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912426297 PECOS PAC ID: 6406209170 Enrollment ID: I20240130000038 |
| Provider Name | Jessica Ruiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346858578 PECOS PAC ID: 4587017272 Enrollment ID: I20240130000452 |
| Provider Name | Audra Alexander Vann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699319202 PECOS PAC ID: 3678926276 Enrollment ID: I20240131000786 |
| Provider Name | Ashlyn Nicole Vinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225683881 PECOS PAC ID: 6507219052 Enrollment ID: I20240131002934 |
| Provider Name | Cecilia Smith Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366942559 PECOS PAC ID: 5193178697 Enrollment ID: I20240131004592 |
| Provider Name | Cindy W Lyman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346567567 PECOS PAC ID: 4688017155 Enrollment ID: I20240212003167 |
| Provider Name | Erik Carlson Weir |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154199354 PECOS PAC ID: 0244674265 Enrollment ID: I20240219000933 |
| Provider Name | Christian Marshall Davidson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164840450 PECOS PAC ID: 0941646111 Enrollment ID: I20240311000636 |
| Provider Name | Chaqueenia Yvette Livingston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023573508 PECOS PAC ID: 6800232851 Enrollment ID: I20240312003669 |
| Provider Name | Clifford Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912173956 PECOS PAC ID: 9133565195 Enrollment ID: I20240312004162 |
| Provider Name | Elizabeth Deboe Vaughan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528557832 PECOS PAC ID: 3072952324 Enrollment ID: I20240418003379 |
| Provider Name | Isis Reddick-umoja |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598875247 PECOS PAC ID: 0749614378 Enrollment ID: I20240423002387 |
| Provider Name | Michelle Lynn Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912205576 PECOS PAC ID: 9032395330 Enrollment ID: I20240429003331 |
| Provider Name | Esther N Nam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003110404 PECOS PAC ID: 3476993981 Enrollment ID: I20240501002263 |
| Provider Name | Frank Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811766959 PECOS PAC ID: 7618317140 Enrollment ID: I20240501002801 |
| Provider Name | Ashley Ramsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639773021 PECOS PAC ID: 1456792167 Enrollment ID: I20240513002307 |
| Provider Name | Shannon Perry-smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922604966 PECOS PAC ID: 2961843545 Enrollment ID: I20240514001904 |
| Provider Name | Elizabeth Anne Bilisoly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710585757 PECOS PAC ID: 5698218097 Enrollment ID: I20240613001896 |
| Provider Name | Rebecca Lynn Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982360889 PECOS PAC ID: 0840733366 Enrollment ID: I20240625000850 |
| Provider Name | Jessica Lynn Roebuck Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902336092 PECOS PAC ID: 9830633858 Enrollment ID: I20240702000864 |
| Provider Name | Rachel Elizabeth Henderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497994875 PECOS PAC ID: 9638614878 Enrollment ID: I20240712000853 |
| Provider Name | Dominique Lemar Vaughan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689192239 PECOS PAC ID: 5193261634 Enrollment ID: I20240722000552 |
| Provider Name | Robbie B Mccraw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629600887 PECOS PAC ID: 4587100862 Enrollment ID: I20240723001971 |
| Provider Name | Sandra Lourdes Mayta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730714163 PECOS PAC ID: 5890232979 Enrollment ID: I20240807001423 |
| Provider Name | Jillian Tuso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720657547 PECOS PAC ID: 2264839489 Enrollment ID: I20241002003359 |
| Provider Name | Anna Grace Tagaram |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790455111 PECOS PAC ID: 7214469048 Enrollment ID: I20241017000904 |
| Provider Name | Breanna Nicholle Ussery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508421694 PECOS PAC ID: 6901338433 Enrollment ID: I20241022001679 |
| Provider Name | Jearilyn Anise Singleton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275887382 PECOS PAC ID: 5092248948 Enrollment ID: I20241030002143 |
| Provider Name | Kimberly Carscaddon Barnett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376310458 PECOS PAC ID: 3779016464 Enrollment ID: I20241104000083 |
| Provider Name | Amarachi Jasmine Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861182735 PECOS PAC ID: 8921532169 Enrollment ID: I20241112000522 |
| Provider Name | Mocha Marie Mims |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063625432 PECOS PAC ID: 2769916808 Enrollment ID: I20241112000948 |
| Provider Name | Nicole Pinna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548957012 PECOS PAC ID: 8729447065 Enrollment ID: I20241112001084 |
| Provider Name | Katelyn Southern Krieger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578161469 PECOS PAC ID: 1153855937 Enrollment ID: I20241115002735 |
| Provider Name | Faith Todd Allman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114759859 PECOS PAC ID: 9335674951 Enrollment ID: I20241119004651 |
| Provider Name | Jason Matthew Mills |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447783097 PECOS PAC ID: 4880129279 Enrollment ID: I20241121003398 |
| Provider Name | Maris Autumn Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811619356 PECOS PAC ID: 6305371758 Enrollment ID: I20241122001070 |
| Provider Name | Winter Albohaire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679221527 PECOS PAC ID: 1759815780 Enrollment ID: I20241127000392 |
| Provider Name | Tanya Joy Cass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295595635 PECOS PAC ID: 4880138783 Enrollment ID: I20241203000109 |
| Provider Name | Natasha Callahan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073286241 PECOS PAC ID: 5395271183 Enrollment ID: I20241203003609 |
| Provider Name | Juliana Rose Zuccarelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417431313 PECOS PAC ID: 0345776043 Enrollment ID: I20241204003755 |
| Provider Name | Brian Distaso |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528890704 PECOS PAC ID: 2567998289 Enrollment ID: I20241204004517 |
| Provider Name | Irene Dormenie Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053927723 PECOS PAC ID: 6901332592 Enrollment ID: I20241205002986 |
| Provider Name | Olivia Faye Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255152898 PECOS PAC ID: 7416483953 Enrollment ID: I20241209000320 |
| Provider Name | Stefanie Renee Mann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487028098 PECOS PAC ID: 3971039397 Enrollment ID: I20241209004066 |
| Provider Name | Jessica P Mujica |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174145619 PECOS PAC ID: 7315473667 Enrollment ID: I20241210001312 |
| Provider Name | Shelton Allison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538377981 PECOS PAC ID: 7416144514 Enrollment ID: I20241217004155 |
| Provider Name | Caroline Forbis Pinkston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194451914 PECOS PAC ID: 3476080011 Enrollment ID: I20241220002440 |
| Provider Name | Nakita Brisbon |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669129763 PECOS PAC ID: 2163959479 Enrollment ID: I20241227002363 |
| Provider Name | Amani D'shea Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548874241 PECOS PAC ID: 5193254233 Enrollment ID: I20250117003383 |
| Provider Name | Elizabeth Kate Webb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114654837 PECOS PAC ID: 4587193164 Enrollment ID: I20250128001145 |
| Provider Name | Courtney Kathleen Kenny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841036209 PECOS PAC ID: 3577092188 Enrollment ID: I20250128002079 |
| Provider Name | Lakeisha M. Ford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417570474 PECOS PAC ID: 3476082884 Enrollment ID: I20250130001938 |
| Provider Name | Lucinda J. Hammond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144366410 PECOS PAC ID: 2668901851 Enrollment ID: I20250203001850 |
| Provider Name | Alyssa Marchand |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851069314 PECOS PAC ID: 9830629997 Enrollment ID: I20250205002038 |
| Provider Name | Bethany L Rainey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447914619 PECOS PAC ID: 9133659022 Enrollment ID: I20250206003398 |
| Provider Name | Jikesha Benton-johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184883886 PECOS PAC ID: 3072969203 Enrollment ID: I20250210001444 |
| Provider Name | Zanita Wiggins Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417528969 PECOS PAC ID: 8921529835 Enrollment ID: I20250307002542 |
| Provider Name | Acacia Victoria Alston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245706100 PECOS PAC ID: 6305369521 Enrollment ID: I20250328001369 |
| Provider Name | Hayley Glenn Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316670573 PECOS PAC ID: 5991229478 Enrollment ID: I20250406000062 |
| Provider Name | Heather B Storck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083411235 PECOS PAC ID: 6406370725 Enrollment ID: I20250408002985 |
| Provider Name | Nicole Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801404025 PECOS PAC ID: 9436674504 Enrollment ID: I20250422001070 |
| Provider Name | Nicole Marie Hairston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699499251 PECOS PAC ID: 3173049905 Enrollment ID: I20250424002554 |
| Provider Name | Gwendolyn Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861022857 PECOS PAC ID: 5597281170 Enrollment ID: I20250428000546 |
| Provider Name | Misty M Brown Pearson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649536152 PECOS PAC ID: 2365969391 Enrollment ID: I20250502003039 |
| Provider Name | Obasi Jaheem Amare |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104377076 PECOS PAC ID: 9133648942 Enrollment ID: I20250523002738 |
| Provider Name | Deborah Fay White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285270892 PECOS PAC ID: 3870012552 Enrollment ID: I20250527001220 |
| Provider Name | Tina Marie Berg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407402886 PECOS PAC ID: 0042721649 Enrollment ID: I20250619000211 |
| Provider Name | Ireland a Gibbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346873379 PECOS PAC ID: 9638685316 Enrollment ID: I20250721000518 |
| Provider Name | Erika Evans-dort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396541041 PECOS PAC ID: 8628584265 Enrollment ID: I20250722000232 |
| Provider Name | Kim Addo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194187286 PECOS PAC ID: 5496263634 Enrollment ID: I20250731001261 |
| Provider Name | Alexis Chanelle Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770203366 PECOS PAC ID: 1850809351 Enrollment ID: I20250805003222 |
| Provider Name | Ammereta Leanna Gaskin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1366946154 PECOS PAC ID: 8426409541 Enrollment ID: I20250822002841 |
| Provider Name | Madeline Comer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760936223 PECOS PAC ID: 0143723700 Enrollment ID: I20250911000014 |
| Provider Name | Adebimpe Olubunmi Onamade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831988153 PECOS PAC ID: 7214430339 Enrollment ID: I20250912003004 |
| Provider Name | Jessica L Agnello |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578116067 PECOS PAC ID: 5991209595 Enrollment ID: I20250917002196 |
| Provider Name | Quentin Aaron Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861002966 PECOS PAC ID: 0840796371 Enrollment ID: I20251002003135 |
| Provider Name | Teresa M. Quick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437224987 PECOS PAC ID: 0042668576 Enrollment ID: I20251003001274 |
| Provider Name | Chesney Anne Fain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326689266 PECOS PAC ID: 9739676784 Enrollment ID: I20251014003076 |
| Provider Name | Selma Zein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639872567 PECOS PAC ID: 1951899053 Enrollment ID: I20251021003592 |
| Provider Name | Nidhi Duggal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154207538 PECOS PAC ID: 2961990791 Enrollment ID: I20251023000213 |
| Provider Name | David Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215627674 PECOS PAC ID: 5890284533 Enrollment ID: I20251031001472 |
| Provider Name | Katie Goldsmith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124708284 PECOS PAC ID: 5991296261 Enrollment ID: I20251114000612 |
| Provider Name | Stephanie Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255091823 PECOS PAC ID: 9133612542 Enrollment ID: I20251204000356 |
| Provider Name | Catherine Mary Bechard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639041452 PECOS PAC ID: 1254826076 Enrollment ID: I20251219000486 |
| Provider Name | Nirva Dieubon-dessalines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003799800 PECOS PAC ID: 3375039548 Enrollment ID: I20251226001880 |
| Provider Name | Katherine O Osborne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154049880 PECOS PAC ID: 7315433174 Enrollment ID: I20251231001224 |
| Provider Name | Gregory Logan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447717350 PECOS PAC ID: 3779079090 Enrollment ID: I20260106003391 |
| Provider Name | Cynthia Lezama-bernal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417599911 PECOS PAC ID: 1850878562 Enrollment ID: I20260123002775 |
| Provider Name | Lacrisha Holcomb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508381369 PECOS PAC ID: 2466939178 Enrollment ID: I20260123002939 |
| Provider Name | Shantele K Weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780566059 PECOS PAC ID: 5890272413 Enrollment ID: I20260124000095 |
| Provider Name | Jerry Dennis Myers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528451721 PECOS PAC ID: 8325527674 Enrollment ID: I20260207000755 |
| Provider Name | Bethany Leigh Radgowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255024055 PECOS PAC ID: 3072092253 Enrollment ID: I20260209001032 |
| Provider Name | Tricia L Speller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861890642 PECOS PAC ID: 2668952045 Enrollment ID: I20260216000208 |
| Provider Name | John Andrew Barber |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1508104381 PECOS PAC ID: 7315428778 Enrollment ID: I20260224001618 |
| Provider Name | Shaelyn Page |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134909385 PECOS PAC ID: 3173005857 Enrollment ID: I20260303001599 |
| Provider Name | Michael Antoine Boulware |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619689825 PECOS PAC ID: 0244708493 Enrollment ID: I20260506000385 |
| Provider Name | Hadley Brochu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447052709 PECOS PAC ID: 1658840046 Enrollment ID: I20260514003311 |
| Provider Name | Brianna Nicole Abbate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760160642 PECOS PAC ID: 2860962560 Enrollment ID: I20260522001680 |
| Provider Name | Abigail Blair Citty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346933959 PECOS PAC ID: 3870063506 Enrollment ID: I20260522002979 |
| Provider Name | Samuel William Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659005627 PECOS PAC ID: 1850861006 Enrollment ID: I20260528002859 |
Wellness Psychiatry Group, P.C. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 249 Williamson Rd, Suite 102, Mooresville, NC 28117 Phone: 704-912-7037 |
Psychiatric Services of Lake Norman Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Joe V. Knox Ave, Suite 104, Mooresville, NC 28117 Phone: 704-663-6660 Fax: 704-663-5343 |
Pinnacle Performance Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 816 Brawley School Rd Ste F1, Mooresville, NC 28117 Phone: 704-799-1270 Fax: 704-799-1271 |
Adaptive Pediatrics Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 249 Williamson Rd Ste 200, Mooresville, NC 28117 Phone: 301-221-5594 |
Matas Counseling Services PLLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 514 Williamson Rd Ste 411, Mooresville, NC 28117 Phone: 704-302-6974 |
The Center at Lake Norman Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Joe Knox Ave Ste 100, Mooresville, NC 28117 Phone: 704-980-9234 Fax: 866-321-9367 |