| Kelly E Bunt Lcsw Pc | |
|
80 Washington St Ste 305 Poughkeepsie NY 12601-2316 | |
| (845) 867-4926 | |
| Not Available |
| Full Name | Kelly E Bunt Lcsw Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 80 Washington St Ste 305, Poughkeepsie, New York |
| Authorized Official Name and Position | Kelly Bunt Bishop (OWNER AND CLINICAL DIRECTOR) |
| Authorized Official Contact | 8458674926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly E Bunt Lcsw Pc 80 Washington St Ste 305 Poughkeepsie NY 12601-2321 Ph: (845) 867-4926 | Kelly E Bunt Lcsw Pc 80 Washington St Ste 305 Poughkeepsie NY 12601-2316 Ph: (845) 867-4926 |
| NPI Number | 1528542057 |
|---|---|
| Provider Enumeration Date | 09/20/2018 |
| Last Update Date | 01/04/2024 |
| Certification Date | 01/04/2024 |
| Medicare PECOS PAC ID | 1951645605 |
|---|---|
| Medicare Enrollment ID | O20181206000951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528542057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jeanne M Desanna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134272180 PECOS PAC ID: 0648455824 Enrollment ID: I20110503000796 |
| Provider Name | Kelly E Bunt-bishop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841581113 PECOS PAC ID: 7315125457 Enrollment ID: I20110621000045 |
| Provider Name | Jonathan Miljus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740542166 PECOS PAC ID: 3779749320 Enrollment ID: I20120725000867 |
| Provider Name | Sherry A Tankersley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588087043 PECOS PAC ID: 7416265624 Enrollment ID: I20151007001291 |
| Provider Name | Jay Herman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598367575 PECOS PAC ID: 9436593555 Enrollment ID: I20240216002286 |
| Provider Name | Brett Alexander Stevens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326604265 PECOS PAC ID: 5991163628 Enrollment ID: I20240712003999 |
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