| Lifestance Health | |
|
215 W Oak St Fl 4 Fort Collins CO 80521-2734 | |
| (970) 310-3406 | |
| Not Available |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Counselor |
| Location | 215 W Oak St Fl 4, Fort Collins, Colorado |
| 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 215 W Oak St Fl 4 Fort Collins CO 80521-2734 Ph: (970) 310-3406 | Lifestance Health 215 W Oak St Fl 4 Fort Collins CO 80521-2734 Ph: (970) 310-3406 |
| NPI Number | 1588038681 |
|---|---|
| Provider Enumeration Date | 11/30/2015 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Medicare PECOS PAC ID | 8628373651 |
|---|---|
| Medicare Enrollment ID | O20160229001522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588038681 | NPI | - | NPPES |
| Provider Name | Eileen D Lang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396811246 PECOS PAC ID: 0345283339 Enrollment ID: I20050610000113 |
| Provider Name | James K Whitney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265508014 PECOS PAC ID: 6103852884 Enrollment ID: I20050713001142 |
| Provider Name | Michael R Wilbourn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508980152 PECOS PAC ID: 0446283204 Enrollment ID: I20050913001086 |
| Provider Name | Mark A Scofield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700886306 PECOS PAC ID: 0941210942 Enrollment ID: I20060504000175 |
| Provider Name | Vanessa B Rollins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093811812 PECOS PAC ID: 6800879412 Enrollment ID: I20061109000491 |
| Provider Name | Mary E Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689626368 PECOS PAC ID: 2668473232 Enrollment ID: I20070124000756 |
| Provider Name | Sheryl J Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568580413 PECOS PAC ID: 3971604729 Enrollment ID: I20070723000736 |
| Provider Name | Julie M Klaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215134705 PECOS PAC ID: 2365535077 Enrollment ID: I20070911000239 |
| Provider Name | Stephanie L Frank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144419581 PECOS PAC ID: 3476643198 Enrollment ID: I20071219000241 |
| Provider Name | Kathleen J Voelsing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811195902 PECOS PAC ID: 6800957960 Enrollment ID: I20081208000216 |
| Provider Name | Cheryl J Buddington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700023785 PECOS PAC ID: 5294891776 Enrollment ID: I20090309000139 |
| Provider Name | Teri Heines |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487819157 PECOS PAC ID: 0840348199 Enrollment ID: I20090427000113 |
| Provider Name | Dana Ashton Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053392449 PECOS PAC ID: 6103974282 Enrollment ID: I20090429000255 |
| Provider Name | Carla J Farris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881845881 PECOS PAC ID: 9436294998 Enrollment ID: I20100308001000 |
| Provider Name | Sharon M Inglis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528258217 PECOS PAC ID: 2163557232 Enrollment ID: I20100315000248 |
| Provider Name | Rebecca K Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699967299 PECOS PAC ID: 5991986879 Enrollment ID: I20110225000037 |
| Provider Name | Deidrea M Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982732426 PECOS PAC ID: 7911183181 Enrollment ID: I20110524000400 |
| Provider Name | Milind S Gadgil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881869642 PECOS PAC ID: 9234307406 Enrollment ID: I20110714000660 |
| Provider Name | Brian G Whitney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700094950 PECOS PAC ID: 2860654746 Enrollment ID: I20120510000587 |
| Provider Name | Marcie Mavreles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811137904 PECOS PAC ID: 0143478099 Enrollment ID: I20120918000522 |
| Provider Name | Susan Elizabeth Mccullough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881836336 PECOS PAC ID: 8527298231 Enrollment ID: I20140225001346 |
| Provider Name | Frances B Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992078232 PECOS PAC ID: 7416170238 Enrollment ID: I20140523001931 |
| Provider Name | Amanda M Moret |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346667441 PECOS PAC ID: 0648495051 Enrollment ID: I20140626002442 |
| Provider Name | Ann M Bomberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255741237 PECOS PAC ID: 5496970485 Enrollment ID: I20140708000113 |
| Provider Name | Joni R Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568504645 PECOS PAC ID: 1052537248 Enrollment ID: I20140724000594 |
| Provider Name | Catherine R O Day |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649486218 PECOS PAC ID: 1658593785 Enrollment ID: I20141118001557 |
| Provider Name | Shaunna C Ostrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932509890 PECOS PAC ID: 7113249459 Enrollment ID: I20141124000431 |
| Provider Name | Taya S Cleveland-keller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114119120 PECOS PAC ID: 6406179639 Enrollment ID: I20141219000980 |
| Provider Name | Alison A Shapiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437554557 PECOS PAC ID: 2668795568 Enrollment ID: I20141230000346 |
| Provider Name | Jenifer Fischer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194023978 PECOS PAC ID: 2668791104 Enrollment ID: I20150505000108 |
| Provider Name | Kirsten Kloock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295126571 PECOS PAC ID: 8628397098 Enrollment ID: I20150506001657 |
| Provider Name | Mardi L Chambers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124412903 PECOS PAC ID: 8527387844 Enrollment ID: I20150507000704 |
| Provider Name | Shantel Gallegos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831576107 PECOS PAC ID: 4880916964 Enrollment ID: I20150601000743 |
| Provider Name | Janese D Smallwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841510930 PECOS PAC ID: 1254581663 Enrollment ID: I20150609000963 |
| Provider Name | Cynthia Geissinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700252772 PECOS PAC ID: 8628385119 Enrollment ID: I20150916000699 |
| Provider Name | Kathryn Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174546956 PECOS PAC ID: 0941517346 Enrollment ID: I20150917001032 |
| Provider Name | Ashley M Sutherland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982954384 PECOS PAC ID: 7719288455 Enrollment ID: I20151222000915 |
| Provider Name | Katherine Kelto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023493939 PECOS PAC ID: 7618270646 Enrollment ID: I20160125001492 |
| Provider Name | Erik J Marsh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851674667 PECOS PAC ID: 8527363498 Enrollment ID: I20160302000291 |
| Provider Name | Laura E Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740318823 PECOS PAC ID: 6507010303 Enrollment ID: I20160307000197 |
| Provider Name | Lauren Boe Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184972291 PECOS PAC ID: 0840504056 Enrollment ID: I20160331000688 |
| Provider Name | Laura Elizabeth Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013381318 PECOS PAC ID: 6406153642 Enrollment ID: I20160401001342 |
| Provider Name | Monica Lynn Bland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871972489 PECOS PAC ID: 4082929526 Enrollment ID: I20160405000875 |
| Provider Name | Michelle Miranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881093607 PECOS PAC ID: 3678792652 Enrollment ID: I20160407000334 |
| Provider Name | Christopher J Roney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891165718 PECOS PAC ID: 5597064469 Enrollment ID: I20160427000797 |
| Provider Name | Randall S Sims |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316399686 PECOS PAC ID: 0143513523 Enrollment ID: I20160722000192 |
| Provider Name | Linda Tuzzolino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144625641 PECOS PAC ID: 6608164082 Enrollment ID: I20161018002231 |
| Provider Name | Cassie L Krajewski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265893697 PECOS PAC ID: 2365724283 Enrollment ID: I20170127002216 |
| Provider Name | Robert Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467803379 PECOS PAC ID: 6901198753 Enrollment ID: I20170302000117 |
| Provider Name | Allison Cherrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619418464 PECOS PAC ID: 5991080442 Enrollment ID: I20170323001112 |
| Provider Name | Deirdre B Fraller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386908861 PECOS PAC ID: 3971751496 Enrollment ID: I20170411002520 |
| Provider Name | Jay Vanderwerff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235565250 PECOS PAC ID: 4486930716 Enrollment ID: I20170420001939 |
| Provider Name | Jennifer L Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730581604 PECOS PAC ID: 5698052157 Enrollment ID: I20170510001684 |
| Provider Name | Dalton Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821173352 PECOS PAC ID: 5991072118 Enrollment ID: I20170518001454 |
| Provider Name | Deborah K Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467740712 PECOS PAC ID: 8224305446 Enrollment ID: I20170518001599 |
| Provider Name | Brittany M Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588071476 PECOS PAC ID: 4587954128 Enrollment ID: I20170612000780 |
| Provider Name | Stephanie Bagwell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114368263 PECOS PAC ID: 4486965480 Enrollment ID: I20170630001933 |
| Provider Name | Brynn Jollay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992036479 PECOS PAC ID: 0749416196 Enrollment ID: I20170712002285 |
| Provider Name | Olivia Oleson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902353550 PECOS PAC ID: 8325319296 Enrollment ID: I20170810003214 |
| Provider Name | Brittani L Schwintosky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124557632 PECOS PAC ID: 1355613159 Enrollment ID: I20170814001841 |
| Provider Name | Daniela Barou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992220867 PECOS PAC ID: 2668745712 Enrollment ID: I20170912000850 |
| Provider Name | Haley Ford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245581826 PECOS PAC ID: 7315212032 Enrollment ID: I20171005003036 |
| Provider Name | Jennifer Burnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417973835 PECOS PAC ID: 6608141999 Enrollment ID: I20171012002487 |
| Provider Name | Caitlin R Walk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235552563 PECOS PAC ID: 3779849690 Enrollment ID: I20171109001575 |
| Provider Name | Kari Dahlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326368416 PECOS PAC ID: 9931465564 Enrollment ID: I20171114002352 |
| Provider Name | Sheri Rockwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902322852 PECOS PAC ID: 5294093894 Enrollment ID: I20180102001908 |
| Provider Name | Monica Massaro Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104140656 PECOS PAC ID: 9032478896 Enrollment ID: I20180124001256 |
| Provider Name | Linda Talarico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649335654 PECOS PAC ID: 2062772304 Enrollment ID: I20180207000942 |
| Provider Name | Jennifer Lynn Le Pont-fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356857197 PECOS PAC ID: 9931469020 Enrollment ID: I20180209002166 |
| Provider Name | Sarah L Masten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336664481 PECOS PAC ID: 5597027474 Enrollment ID: I20180314000019 |
| Provider Name | Kenyatta Merriweather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619228558 PECOS PAC ID: 9638320302 Enrollment ID: I20180423001748 |
| Provider Name | Amy Healy-krumwiede |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679819940 PECOS PAC ID: 5597055335 Enrollment ID: I20180425000168 |
| Provider Name | Molly Torvik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003291584 PECOS PAC ID: 0446514905 Enrollment ID: I20180509000451 |
| Provider Name | Lawrence L Gardner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619991684 PECOS PAC ID: 0244491223 Enrollment ID: I20180517002145 |
| Provider Name | Stephen A Valente |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154841054 PECOS PAC ID: 4183989064 Enrollment ID: I20180523002590 |
| Provider Name | Stacey Elaine Salmonson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649761180 PECOS PAC ID: 2163777566 Enrollment ID: I20180625003601 |
| Provider Name | Chelsea Carpenter Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871088617 PECOS PAC ID: 6406102920 Enrollment ID: I20180712003065 |
| Provider Name | Laurie Hessel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851871230 PECOS PAC ID: 8022368653 Enrollment ID: I20180831002018 |
| Provider Name | Kristina Elizabeth Glover |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013272350 PECOS PAC ID: 0345472395 Enrollment ID: I20180920002341 |
| Provider Name | Sonia Christina Izmirian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932481538 PECOS PAC ID: 7618229824 Enrollment ID: I20181016001015 |
| Provider Name | Mary E Cooley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962509943 PECOS PAC ID: 4183977283 Enrollment ID: I20181018001983 |
| Provider Name | Lisa M Rich |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164906194 PECOS PAC ID: 2365795424 Enrollment ID: I20181019001605 |
| Provider Name | Thomas Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992218374 PECOS PAC ID: 9830443803 Enrollment ID: I20181109000600 |
| Provider Name | Lauri J Lohse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821101973 PECOS PAC ID: 6507962701 Enrollment ID: I20181114002812 |
| Provider Name | Kendall R Kershner-rice |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144502352 PECOS PAC ID: 8224382924 Enrollment ID: I20181115002225 |
| Provider Name | Sarah Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962953901 PECOS PAC ID: 2860775343 Enrollment ID: I20181117000045 |
| Provider Name | Reena M Camoens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467434910 PECOS PAC ID: 4183657844 Enrollment ID: I20181130000727 |
| Provider Name | Tracy L Heinz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811225337 PECOS PAC ID: 2567760234 Enrollment ID: I20181206002188 |
| Provider Name | Valeria Isabel Rojo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447703715 PECOS PAC ID: 9537407705 Enrollment ID: I20190213001684 |
| Provider Name | Marcella Camille Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295958783 PECOS PAC ID: 4486694767 Enrollment ID: I20190215001326 |
| Provider Name | Roxanne Hotchkiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982857132 PECOS PAC ID: 3072662550 Enrollment ID: I20190219000631 |
| Provider Name | Traci Leigh Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588814636 PECOS PAC ID: 0042559775 Enrollment ID: I20190225001896 |
| Provider Name | Jennifer Cirak Huskinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811466071 PECOS PAC ID: 6507105772 Enrollment ID: I20190306000203 |
| Provider Name | Linsey E. Norton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407243413 PECOS PAC ID: 3678815347 Enrollment ID: I20190429001808 |
| Provider Name | Abigail Towe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750866885 PECOS PAC ID: 0941542377 Enrollment ID: I20190503001149 |
| Provider Name | Heather Lynn Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598328346 PECOS PAC ID: 2163764309 Enrollment ID: I20190508002011 |
| Provider Name | Linda Laverne Keddington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760675953 PECOS PAC ID: 6204923493 Enrollment ID: I20190610002765 |
| Provider Name | Shannon J Cahill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073999330 PECOS PAC ID: 5496089609 Enrollment ID: I20190621001808 |
| Provider Name | Melanie Creach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588223101 PECOS PAC ID: 7517291610 Enrollment ID: I20190624002117 |
| Provider Name | Jesse Hazel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972053973 PECOS PAC ID: 6002197282 Enrollment ID: I20190625001021 |
| Provider Name | Nicholas J Boeder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851786446 PECOS PAC ID: 7911287230 Enrollment ID: I20190703000430 |
| Provider Name | Christal L Lichtenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295391910 PECOS PAC ID: 0941535066 Enrollment ID: I20190711002646 |
| Provider Name | Cassidy Shults |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639483118 PECOS PAC ID: 9032445366 Enrollment ID: I20190724003527 |
| Provider Name | Eric Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437651643 PECOS PAC ID: 3971831405 Enrollment ID: I20190822000764 |
| Provider Name | Anne R Shaul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457438871 PECOS PAC ID: 2163750498 Enrollment ID: I20190826000500 |
| Provider Name | Corey A Hollowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083090757 PECOS PAC ID: 7517296809 Enrollment ID: I20190911003803 |
| Provider Name | Ann Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659927309 PECOS PAC ID: 3375873078 Enrollment ID: I20190923003043 |
| Provider Name | Timothy C Woodworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477679082 PECOS PAC ID: 0840520565 Enrollment ID: I20190924000343 |
| Provider Name | Chelsea Peck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033765649 PECOS PAC ID: 3375873672 Enrollment ID: I20190930003082 |
| Provider Name | Tamara Kane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043860729 PECOS PAC ID: 2365773280 Enrollment ID: I20191008001002 |
| Provider Name | Sarah Mobley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902238041 PECOS PAC ID: 7911207733 Enrollment ID: I20191016002779 |
| Provider Name | Ashley Cahill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992151674 PECOS PAC ID: 0749511152 Enrollment ID: I20191016003175 |
| Provider Name | Alyssa Fieseler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457902835 PECOS PAC ID: 2466784079 Enrollment ID: I20191031002555 |
| Provider Name | Jordan B Hout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700439353 PECOS PAC ID: 3971936931 Enrollment ID: I20191204002574 |
| Provider Name | Corey Nielsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013445717 PECOS PAC ID: 1658704499 Enrollment ID: I20191209001257 |
| Provider Name | Allison Michelle Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891033684 PECOS PAC ID: 1951734441 Enrollment ID: I20191216000593 |
| Provider Name | Thomas Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538598487 PECOS PAC ID: 7810210952 Enrollment ID: I20200113000818 |
| Provider Name | Lisa Ann Dashnaw Stiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457833568 PECOS PAC ID: 5092966366 Enrollment ID: I20200128002181 |
| Provider Name | Robert Jay Didericksen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407231244 PECOS PAC ID: 0143656710 Enrollment ID: I20200130002604 |
| Provider Name | Anna Michelle Libby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205168622 PECOS PAC ID: 7214365832 Enrollment ID: I20200313001676 |
| Provider Name | Susan Seiler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265722151 PECOS PAC ID: 4385822576 Enrollment ID: I20200331000863 |
| Provider Name | Catherine Mielcarz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649713835 PECOS PAC ID: 4183053838 Enrollment ID: I20200401002829 |
| Provider Name | Jessica Marie Shiveley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326677360 PECOS PAC ID: 2264863497 Enrollment ID: I20200504000484 |
| Provider Name | Darlyn Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841629888 PECOS PAC ID: 0941631550 Enrollment ID: I20200515000479 |
| Provider Name | Timothy Gannon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508952847 PECOS PAC ID: 0042101875 Enrollment ID: I20200522000553 |
| Provider Name | Lori Truetzschler-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033657515 PECOS PAC ID: 2567746019 Enrollment ID: I20200615003256 |
| Provider Name | Emily Hope Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770106510 PECOS PAC ID: 2365864386 Enrollment ID: I20200622000762 |
| Provider Name | Samantha Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831647437 PECOS PAC ID: 9032498373 Enrollment ID: I20200625000334 |
| Provider Name | Matthew W Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093330912 PECOS PAC ID: 8022432673 Enrollment ID: I20200716000218 |
| Provider Name | Marjory Strawn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881097707 PECOS PAC ID: 1355765868 Enrollment ID: I20200716002635 |
| Provider Name | Sydney Soucek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487279600 PECOS PAC ID: 4183048648 Enrollment ID: I20200717000190 |
| Provider Name | Jackie Heintz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386181790 PECOS PAC ID: 0345664736 Enrollment ID: I20200717001591 |
| Provider Name | Leslie Ann Merriman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114281888 PECOS PAC ID: 4486078243 Enrollment ID: I20200727001409 |
| Provider Name | Adam Ovadia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255786760 PECOS PAC ID: 8729404058 Enrollment ID: I20200818001909 |
| Provider Name | Jami Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629635719 PECOS PAC ID: 9638502248 Enrollment ID: I20200818002331 |
| Provider Name | Samantha Wall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306315999 PECOS PAC ID: 5799101952 Enrollment ID: I20200818003179 |
| Provider Name | Tessa Fox Kulakowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558779801 PECOS PAC ID: 6103242201 Enrollment ID: I20200820000194 |
| Provider Name | Anne Knack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639631419 PECOS PAC ID: 5193142909 Enrollment ID: I20200825002010 |
| Provider Name | Ashley M Benally-ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073121943 PECOS PAC ID: 2769809409 Enrollment ID: I20200826003560 |
| Provider Name | Alexandra Basile |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306248943 PECOS PAC ID: 3072931831 Enrollment ID: I20200911000348 |
| Provider Name | Sandra M Gerardo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649422312 PECOS PAC ID: 4082033006 Enrollment ID: I20200924001770 |
| Provider Name | Alexander Ariel Regalado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982095642 PECOS PAC ID: 3779903851 Enrollment ID: I20201009002368 |
| Provider Name | Joanna Deane Lippert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841524287 PECOS PAC ID: 1355761347 Enrollment ID: I20201013001196 |
| Provider Name | Asha Laine Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245540319 PECOS PAC ID: 6800216714 Enrollment ID: I20201014003708 |
| Provider Name | Sarah Stockham Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932710365 PECOS PAC ID: 9133549900 Enrollment ID: I20201015002904 |
| Provider Name | Erin Appell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144670365 PECOS PAC ID: 3678993466 Enrollment ID: I20201016000526 |
| Provider Name | Janelle Adrienne Cendana Aguilon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083224695 PECOS PAC ID: 8921428764 Enrollment ID: I20201016002722 |
| Provider Name | Alexander Otis Kisor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205435336 PECOS PAC ID: 4486064326 Enrollment ID: I20201105000370 |
| Provider Name | Ashley Nichole Wiggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144822859 PECOS PAC ID: 0941611982 Enrollment ID: I20201124001825 |
| Provider Name | Alyssa Nadolny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922629914 PECOS PAC ID: 6103237797 Enrollment ID: I20201203001644 |
| Provider Name | Rebecca Frank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568007193 PECOS PAC ID: 2365854882 Enrollment ID: I20201207001845 |
| Provider Name | Jose Vasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649278318 PECOS PAC ID: 6709821945 Enrollment ID: I20201208000227 |
| Provider Name | Jason Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609029198 PECOS PAC ID: 7810309846 Enrollment ID: I20201216002652 |
| Provider Name | Barbara Patricia Dsouza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376579979 PECOS PAC ID: 7012996481 Enrollment ID: I20201229000744 |
| Provider Name | Jordyn Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063975837 PECOS PAC ID: 9133532419 Enrollment ID: I20210105002051 |
| Provider Name | Jessica Patricia Courtney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144821042 PECOS PAC ID: 2365855525 Enrollment ID: I20210106002854 |
| Provider Name | Breanna Leigh Katz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447780911 PECOS PAC ID: 3274876370 Enrollment ID: I20210112000889 |
| Provider Name | Alberto D Luna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215308929 PECOS PAC ID: 1254633852 Enrollment ID: I20210113002058 |
| Provider Name | Ivy Gugat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487258968 PECOS PAC ID: 6305250556 Enrollment ID: I20210128002604 |
| Provider Name | Shelby Keyworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780274753 PECOS PAC ID: 5193139129 Enrollment ID: I20210202002037 |
| Provider Name | Debra Lynn Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053901785 PECOS PAC ID: 2365857059 Enrollment ID: I20210210000538 |
| Provider Name | Dieunette Joseph-omwanghe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912593385 PECOS PAC ID: 4183039555 Enrollment ID: I20210216003376 |
| Provider Name | Kelly Lenn Yeldell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366676249 PECOS PAC ID: 9638585599 Enrollment ID: I20210302000357 |
| Provider Name | Danielle Renee Reeves-luther |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336523380 PECOS PAC ID: 7719393453 Enrollment ID: I20210304001367 |
| Provider Name | Shannon Booker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437742012 PECOS PAC ID: 5799192530 Enrollment ID: I20210324000305 |
| Provider Name | Syretta Mcgraw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083203590 PECOS PAC ID: 7810304086 Enrollment ID: I20210406001204 |
| Provider Name | Alicia Maria Matheson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942881131 PECOS PAC ID: 5092123422 Enrollment ID: I20210422002585 |
| Provider Name | Tiffany Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760009617 PECOS PAC ID: 1759790819 Enrollment ID: I20210503001220 |
| Provider Name | Kristen A Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023631868 PECOS PAC ID: 0143639211 Enrollment ID: I20210503001533 |
| Provider Name | Wojciech L Seweryn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811206170 PECOS PAC ID: 1153730155 Enrollment ID: I20210504000469 |
| Provider Name | Christie Lynn Kraeger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467722405 PECOS PAC ID: 0749699205 Enrollment ID: I20210513000155 |
| Provider Name | Sabrah Jean Collar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952989204 PECOS PAC ID: 9830599273 Enrollment ID: I20210607002254 |
| Provider Name | Chelsea Elizabeth Twiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881172377 PECOS PAC ID: 3870996689 Enrollment ID: I20210730000267 |
| Provider Name | Amanda Kay Padgett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689225054 PECOS PAC ID: 0446654339 Enrollment ID: I20210816000805 |
| Provider Name | James Wilkerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730493560 PECOS PAC ID: 5890191563 Enrollment ID: I20210903000309 |
| Provider Name | Melodie Sue Nicholas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699901728 PECOS PAC ID: 7214333509 Enrollment ID: I20210913001163 |
| Provider Name | Jill Kathleen Boatwright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952940439 PECOS PAC ID: 1254737380 Enrollment ID: I20210915000118 |
| Provider Name | Jennifer Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902422801 PECOS PAC ID: 0345647889 Enrollment ID: I20210924002675 |
| Provider Name | Kimberly Diane Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528639630 PECOS PAC ID: 2860890720 Enrollment ID: I20211006002174 |
| Provider Name | Jillian R Luttrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518440924 PECOS PAC ID: 1052664810 Enrollment ID: I20211019001926 |
| Provider Name | Rebecca Ann Rottinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518361153 PECOS PAC ID: 5294123832 Enrollment ID: I20211101000948 |
| Provider Name | Narcie Channell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942880372 PECOS PAC ID: 8123416534 Enrollment ID: I20211103002043 |
| Provider Name | Jessica Schmalz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538754064 PECOS PAC ID: 3476942897 Enrollment ID: I20211105000035 |
| Provider Name | Haley Lafferty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093485500 PECOS PAC ID: 6002205085 Enrollment ID: I20211112000609 |
| Provider Name | Hannah Lee Poore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396218194 PECOS PAC ID: 3971992959 Enrollment ID: I20211112000764 |
| Provider Name | Rebecca Waller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427531318 PECOS PAC ID: 0840689626 Enrollment ID: I20211117000072 |
| Provider Name | Terri Lynn Rommel-ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881363844 PECOS PAC ID: 1850780651 Enrollment ID: I20211117000936 |
| Provider Name | Kristine Froehlich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023770823 PECOS PAC ID: 3971992694 Enrollment ID: I20211117002328 |
| Provider Name | Shaina Mae Crisp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144987298 PECOS PAC ID: 1850782715 Enrollment ID: I20220104000017 |
| Provider Name | Michael Wyskiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295401214 PECOS PAC ID: 7012308927 Enrollment ID: I20220104002150 |
| Provider Name | Lori Neiswanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861017006 PECOS PAC ID: 5799177341 Enrollment ID: I20220112000641 |
| Provider Name | Kayla Day Krug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669863387 PECOS PAC ID: 3577955079 Enrollment ID: I20220113000099 |
| Provider Name | Brett M Springer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952941536 PECOS PAC ID: 7416349766 Enrollment ID: I20220118000693 |
| Provider Name | Kathryn Alysa Sheek Grice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386048635 PECOS PAC ID: 7810389194 Enrollment ID: I20220118002021 |
| Provider Name | Amanda Tinkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023594819 PECOS PAC ID: 5890187900 Enrollment ID: I20220124001389 |
| Provider Name | Mckenna Teague |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356980239 PECOS PAC ID: 3072906791 Enrollment ID: I20220201002664 |
| Provider Name | Stacy Amanda Lindsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922510544 PECOS PAC ID: 3173941598 Enrollment ID: I20220301001966 |
| Provider Name | Kenna Rae Brauchler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518569946 PECOS PAC ID: 7214322502 Enrollment ID: I20220323002675 |
| Provider Name | Marinda Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457992570 PECOS PAC ID: 1850623570 Enrollment ID: I20220412002237 |
| Provider Name | Amanda Lillian Meltzer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104951144 PECOS PAC ID: 2769650142 Enrollment ID: I20220421001040 |
| Provider Name | Brianna Renee Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205581303 PECOS PAC ID: 6800283631 Enrollment ID: I20220426003039 |
| Provider Name | Rachel Morrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710635180 PECOS PAC ID: 1850778606 Enrollment ID: I20220517000003 |
| Provider Name | Indizo Star Moon Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215394820 PECOS PAC ID: 4284011032 Enrollment ID: I20220517000099 |
| Provider Name | Christa Marie Aslanian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649923947 PECOS PAC ID: 5890174205 Enrollment ID: I20220615000993 |
| Provider Name | Megan Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902340185 PECOS PAC ID: 5799164331 Enrollment ID: I20220628001410 |
| Provider Name | Kelsie Ty Gauchay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427605559 PECOS PAC ID: 3173904596 Enrollment ID: I20220718000664 |
| Provider Name | Brea Deann Kilpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003558362 PECOS PAC ID: 3072994078 Enrollment ID: I20220722000568 |
| Provider Name | Reynel Mirabal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700384112 PECOS PAC ID: 5991188658 Enrollment ID: I20220815000154 |
| Provider Name | Brittany Roper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447995931 PECOS PAC ID: 7315320835 Enrollment ID: I20220816003700 |
| Provider Name | Amber Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598496234 PECOS PAC ID: 7517340573 Enrollment ID: I20220824001398 |
| Provider Name | Kathleen Marie Largent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831831932 PECOS PAC ID: 1759765498 Enrollment ID: I20220830003233 |
| Provider Name | Colton Braucher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568090553 PECOS PAC ID: 2769806454 Enrollment ID: I20220831000889 |
| Provider Name | Austin Thomas Kopas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912590084 PECOS PAC ID: 6709282866 Enrollment ID: I20220908002324 |
| Provider Name | Briana Payne Laurie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356934756 PECOS PAC ID: 0244615375 Enrollment ID: I20220909002554 |
| Provider Name | Michelle Cativo-zetino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205261666 PECOS PAC ID: 2264869858 Enrollment ID: I20220919000779 |
| Provider Name | Rachael Cruze |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487380614 PECOS PAC ID: 1456736651 Enrollment ID: I20220923000161 |
| Provider Name | Soraya N Jallad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770903122 PECOS PAC ID: 1355681305 Enrollment ID: I20221003003177 |
| Provider Name | Shannon Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740908961 PECOS PAC ID: 3870969173 Enrollment ID: I20221011001961 |
| Provider Name | Stephanie Louise Coates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629727771 PECOS PAC ID: 1658747704 Enrollment ID: I20221014002052 |
| Provider Name | Kelsey M Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376907758 PECOS PAC ID: 5496122319 Enrollment ID: I20221107001973 |
| Provider Name | Katie Croft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679095418 PECOS PAC ID: 4789051582 Enrollment ID: I20221108002131 |
| Provider Name | Cammie Ann Sangeet Kleinz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891360558 PECOS PAC ID: 5092183475 Enrollment ID: I20221115003109 |
| Provider Name | Amanda May Upthegrove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548835291 PECOS PAC ID: 0345618351 Enrollment ID: I20221123001092 |
| Provider Name | Neeva Carley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528633948 PECOS PAC ID: 2860863222 Enrollment ID: I20230122000048 |
| Provider Name | Amanda Joan Edmiston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548906720 PECOS PAC ID: 5698146850 Enrollment ID: I20230126000042 |
| Provider Name | Angela Michelle Gaumond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396361986 PECOS PAC ID: 6305217340 Enrollment ID: I20230130001584 |
| Provider Name | Barbara Howes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790063394 PECOS PAC ID: 8820227010 Enrollment ID: I20230202003354 |
| Provider Name | Audrey E Davis, Lcsw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073047783 PECOS PAC ID: 6608248463 Enrollment ID: I20230206000355 |
| Provider Name | Kelly B Love |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043468994 PECOS PAC ID: 8325171606 Enrollment ID: I20230210000431 |
| Provider Name | Natasha Elliott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396122644 PECOS PAC ID: 1456723709 Enrollment ID: I20230214001820 |
| Provider Name | Katelyn Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588289904 PECOS PAC ID: 2365815024 Enrollment ID: I20230227003056 |
| Provider Name | Dailyn Somoza Menendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831730688 PECOS PAC ID: 3577937788 Enrollment ID: I20230329001565 |
| Provider Name | Aimee Mclaurin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598464604 PECOS PAC ID: 7810362068 Enrollment ID: I20230331001655 |
| Provider Name | Avi-natan Zadaka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154927226 PECOS PAC ID: 5597130765 Enrollment ID: I20230331002624 |
| Provider Name | Hannah Hinchsliff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801594486 PECOS PAC ID: 5698140663 Enrollment ID: I20230404001930 |
| Provider Name | Elizabeth Ann Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184256026 PECOS PAC ID: 6507231263 Enrollment ID: I20230411001181 |
| Provider Name | Alexander Tucker Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497429740 PECOS PAC ID: 6709241946 Enrollment ID: I20230424000826 |
| Provider Name | Jillian Olney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972207843 PECOS PAC ID: 6608231873 Enrollment ID: I20230424001872 |
| Provider Name | Caroline Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932847597 PECOS PAC ID: 2062877640 Enrollment ID: I20230504000514 |
| Provider Name | Stephanie Flora Marsella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023719028 PECOS PAC ID: 1052776549 Enrollment ID: I20230505002190 |
| Provider Name | Elise Ann Salas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699108308 PECOS PAC ID: 6204292857 Enrollment ID: I20230524000350 |
| Provider Name | Annaken S. Toews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205531019 PECOS PAC ID: 6709243009 Enrollment ID: I20230601000099 |
| Provider Name | Julie Anne Bremer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518613934 PECOS PAC ID: 7113384934 Enrollment ID: I20230608002608 |
| Provider Name | Jennifer Kim Pries |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336831692 PECOS PAC ID: 5991162588 Enrollment ID: I20230613003312 |
| Provider Name | Meghan Ruich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902378466 PECOS PAC ID: 6709266356 Enrollment ID: I20230619001005 |
| Provider Name | Ghea Mae Tiping Degillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790384451 PECOS PAC ID: 6406216746 Enrollment ID: I20230718001599 |
| Provider Name | Jacquelyn Batterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609381425 PECOS PAC ID: 7416215413 Enrollment ID: I20230731001014 |
| Provider Name | Hannah Bailey Glasrud |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811506926 PECOS PAC ID: 4981067063 Enrollment ID: I20230823002027 |
| Provider Name | Nicole Csw Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902402712 PECOS PAC ID: 5799148417 Enrollment ID: I20230829002309 |
| Provider Name | Jennifer Mcnaughton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831867589 PECOS PAC ID: 2567816655 Enrollment ID: I20230922002317 |
| Provider Name | Sherra Stclair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639729056 PECOS PAC ID: 8729416599 Enrollment ID: I20230925002851 |
| Provider Name | Hannah Marie Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477216976 PECOS PAC ID: 8022464361 Enrollment ID: I20231024000393 |
| Provider Name | Gregory A. Prince |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538218144 PECOS PAC ID: 0547618928 Enrollment ID: I20231122003062 |
| Provider Name | Katherine D Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588751465 PECOS PAC ID: 4183074057 Enrollment ID: I20231219002864 |
| Provider Name | Mara Talin Minasian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033724976 PECOS PAC ID: 4183044381 Enrollment ID: I20231222000261 |
| Provider Name | Daniela Rosenberg Paiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194263251 PECOS PAC ID: 9931559382 Enrollment ID: I20231227001185 |
| Provider Name | Marcia Michelle Vincent |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740769918 PECOS PAC ID: 2365892320 Enrollment ID: I20240103002075 |
| Provider Name | Michele Marostica |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942865639 PECOS PAC ID: 3577914340 Enrollment ID: I20240105000730 |
| Provider Name | Julie Ann Darter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417512633 PECOS PAC ID: 5890146138 Enrollment ID: I20240110004607 |
| Provider Name | Marlee J Cavallero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831707025 PECOS PAC ID: 1052763489 Enrollment ID: I20240122000717 |
| Provider Name | Rebecca Hooper-esquibel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114443017 PECOS PAC ID: 5597118299 Enrollment ID: I20240130000719 |
| Provider Name | Lily Amelia Mathison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689270886 PECOS PAC ID: 1951790484 Enrollment ID: I20240130000741 |
| Provider Name | Rena Diem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730470055 PECOS PAC ID: 2769835339 Enrollment ID: I20240131000062 |
| Provider Name | Patrica Anne Zeyher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760038723 PECOS PAC ID: 8820431604 Enrollment ID: I20240208002173 |
| Provider Name | Emily Travis Peterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275292112 PECOS PAC ID: 8123461746 Enrollment ID: I20240209002789 |
| Provider Name | Pamela Herrick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306398144 PECOS PAC ID: 7113361122 Enrollment ID: I20240219000490 |
| Provider Name | Allyson Marie Burns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851993331 PECOS PAC ID: 5092159863 Enrollment ID: I20240220003009 |
| Provider Name | Steve Swan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427512383 PECOS PAC ID: 6103261664 Enrollment ID: I20240223004190 |
| Provider Name | Geoffery D Phillip |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821408980 PECOS PAC ID: 5991140717 Enrollment ID: I20240301002632 |
| Provider Name | Sarah Van Norden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336719541 PECOS PAC ID: 1658716410 Enrollment ID: I20240301003823 |
| Provider Name | Brittany Ann White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902463805 PECOS PAC ID: 2163867888 Enrollment ID: I20240304001449 |
| Provider Name | Sahara Omar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942884994 PECOS PAC ID: 0941645683 Enrollment ID: I20240304002371 |
| Provider Name | Kristin Gayden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306121272 PECOS PAC ID: 3274978945 Enrollment ID: I20240304003387 |
| Provider Name | Natalie Van Note |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114296027 PECOS PAC ID: 1456796143 Enrollment ID: I20240305000040 |
| Provider Name | Breanna Sieck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154839025 PECOS PAC ID: 6204271851 Enrollment ID: I20240305002255 |
| Provider Name | Jami B Hedrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134580566 PECOS PAC ID: 5294170874 Enrollment ID: I20240305003605 |
| Provider Name | Lana Nye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780167825 PECOS PAC ID: 6507221785 Enrollment ID: I20240308001810 |
| Provider Name | Jessie Stempel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679023238 PECOS PAC ID: 4880030006 Enrollment ID: I20240311002526 |
| Provider Name | Ashlei M Kretz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700107919 PECOS PAC ID: 2961848957 Enrollment ID: I20240313001005 |
| Provider Name | Joy Ann Weigel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639767684 PECOS PAC ID: 6507202421 Enrollment ID: I20240313002215 |
| Provider Name | Jacquelyn Girdlestone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093110835 PECOS PAC ID: 6305282005 Enrollment ID: I20240315000957 |
Wallace Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4115 Boardwalk Dr, Suite 200, Fort Collins, CO 80525 Phone: 970-817-4049 Fax: 877-833-4460 | |
Connect Therapies Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1502 S College Ave, Fort Collins, CO 80524 Phone: 907-663-1065 | |
Strong Hope Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2850 Mcclelland Dr Ste 2400, Fort Collins, CO 80525 Phone: 541-380-1622 | |
Alchemy Counseling, Consultation, And Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Mathews St Ste 300, Fort Collins, CO 80524 Phone: 970-217-7796 | |
Jill A. Kuhn, Ph.d. L.l.c Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 323 W Drake Rd, Suite 220, Fort Collins, CO 80526 Phone: 970-219-9206 | |
Monica Rowell Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4115 Boardwalk Dr, Suite 100, Fort Collins, CO 80525 Phone: 970-493-4580 | |
Summitstone Health Partners Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Skyway Dr, Fort Collins, CO 80525 Phone: 970-494-4200 |