| Downriver Mental Health Clinic Pc | |
|
20500 Eureka Rd Suite 200 Taylor MI 48180-6394 | |
| (734) 285-8282 | |
| (734) 281-0402 |
| Full Name | Downriver Mental Health Clinic Pc |
|---|---|
| Speciality | Psychologist |
| Location | 20500 Eureka Rd, Taylor, Michigan |
| Authorized Official Name and Position | Ryan Pardo (CHEIF 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 |
|---|---|
| Downriver Mental Health Clinic Pc 20500 Eureka Rd Suite 200 Taylor MI 48180-6394 Ph: (734) 285-8282 | Downriver Mental Health Clinic Pc 20500 Eureka Rd Suite 200 Taylor MI 48180-6394 Ph: (734) 285-8282 |
| NPI Number | 1295866135 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 01/15/2025 |
| Certification Date | 01/15/2025 |
| Medicare PECOS PAC ID | 7911995139 |
|---|---|
| Medicare Enrollment ID | O20040505000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295866135 | NPI | - | NPPES |
| 7509203930 | Other | MI | BCBS SA |
| Provider Name | Ronald H Bradley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568408615 PECOS PAC ID: 9032000823 Enrollment ID: I20040322001658 |
| Provider Name | Kurt L Richards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801916317 PECOS PAC ID: 7517945934 Enrollment ID: I20040712001242 |
| Provider Name | Gerri L Hagadon-szakal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831193358 PECOS PAC ID: 4385611433 Enrollment ID: I20040916000819 |
| Provider Name | Bonnie C Miriani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932253218 PECOS PAC ID: 4284602244 Enrollment ID: I20040917001186 |
| Provider Name | David A Picone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568575579 PECOS PAC ID: 4587624770 Enrollment ID: I20041013000541 |
| Provider Name | Roy J Meland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376500330 PECOS PAC ID: 7315907508 Enrollment ID: I20041013000582 |
| Provider Name | Erlinda Mercado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790898278 PECOS PAC ID: 0446216782 Enrollment ID: I20041208000251 |
| Provider Name | Nonnie Lee Humphreys |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720004567 PECOS PAC ID: 1759335805 Enrollment ID: I20050310000884 |
| Provider Name | Maria Lai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538216254 PECOS PAC ID: 2466495767 Enrollment ID: I20050608000024 |
| Provider Name | James F Loree |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114960754 PECOS PAC ID: 5991740565 Enrollment ID: I20050623000642 |
| Provider Name | Katrina Denise Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053399337 PECOS PAC ID: 2961423173 Enrollment ID: I20051215000641 |
| Provider Name | Borhan I Rais |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891748455 PECOS PAC ID: 5799798104 Enrollment ID: I20060731000451 |
| Provider Name | Jeffrey A Kezlarian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548351075 PECOS PAC ID: 5193722437 Enrollment ID: I20061031000173 |
| Provider Name | Charles L Pearlstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356401947 PECOS PAC ID: 5395848352 Enrollment ID: I20070312000370 |
| Provider Name | Janet L Onesian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588684302 PECOS PAC ID: 0244331205 Enrollment ID: I20070720000788 |
| Provider Name | Maria V Merritt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619035433 PECOS PAC ID: 2567554751 Enrollment ID: I20070817000123 |
| Provider Name | James Hillard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700966785 PECOS PAC ID: 1850365453 Enrollment ID: I20080126000068 |
| Provider Name | Rishi N Mahabir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215144340 PECOS PAC ID: 5294819587 Enrollment ID: I20080226000168 |
| Provider Name | Cheryl A Fregolle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477598696 PECOS PAC ID: 9638248693 Enrollment ID: I20080516000023 |
| Provider Name | Lashawn Myers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588840912 PECOS PAC ID: 3577633866 Enrollment ID: I20080529000222 |
| Provider Name | Laurie M Kuehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710137294 PECOS PAC ID: 8628138518 Enrollment ID: I20081121000617 |
| Provider Name | Melinda K Ryde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548387061 PECOS PAC ID: 3779645528 Enrollment ID: I20090105000020 |
| Provider Name | Malini R Shenava |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336248905 PECOS PAC ID: 1951350909 Enrollment ID: I20090209000088 |
| Provider Name | Brenda Jean Pontillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699809541 PECOS PAC ID: 8527124015 Enrollment ID: I20090309000287 |
| Provider Name | Susan H Rohde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043370455 PECOS PAC ID: 8729137534 Enrollment ID: I20090528000234 |
| Provider Name | Diane C Piszker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619147790 PECOS PAC ID: 9638229016 Enrollment ID: I20090604000595 |
| Provider Name | Laura M Bennington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841473998 PECOS PAC ID: 8628121811 Enrollment ID: I20090805000738 |
| Provider Name | Sandra Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497879159 PECOS PAC ID: 2961532239 Enrollment ID: I20100612000059 |
| Provider Name | Daniel J Petersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740458538 PECOS PAC ID: 1759412984 Enrollment ID: I20100701000389 |
| Provider Name | Liza Raymond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508915562 PECOS PAC ID: 7911191499 Enrollment ID: I20101028000786 |
| Provider Name | Niaz Mohammad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437352689 PECOS PAC ID: 8224222450 Enrollment ID: I20101102000653 |
| Provider Name | Bernard Ball |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184640187 PECOS PAC ID: 8426243445 Enrollment ID: I20101116000274 |
| Provider Name | Margaret M Keeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568553741 PECOS PAC ID: 3577759802 Enrollment ID: I20101129000105 |
| Provider Name | Charlotte Beachem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316126824 PECOS PAC ID: 9032308556 Enrollment ID: I20110113000706 |
| Provider Name | Syeda Y Mohammad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053336396 PECOS PAC ID: 8224026455 Enrollment ID: I20110118000623 |
| Provider Name | Vanessa M Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124049986 PECOS PAC ID: 1658550850 Enrollment ID: I20110120000175 |
| Provider Name | Shari Ann Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538490057 PECOS PAC ID: 6901088483 Enrollment ID: I20110303000974 |
| Provider Name | Sheila G Crowell-henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871559328 PECOS PAC ID: 8123206083 Enrollment ID: I20110623000135 |
| Provider Name | Raed H Yousif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386858603 PECOS PAC ID: 9739358144 Enrollment ID: I20110801000488 |
| Provider Name | Jeffrey A Frey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013180744 PECOS PAC ID: 6709057508 Enrollment ID: I20110928000336 |
| Provider Name | Robert E Demercurio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992833396 PECOS PAC ID: 1254464522 Enrollment ID: I20111021000564 |
| Provider Name | Jenna L Chambless |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1114209988 PECOS PAC ID: 7113190380 Enrollment ID: I20111103000293 |
| Provider Name | Neil Talon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851401368 PECOS PAC ID: 3173796117 Enrollment ID: I20111107000827 |
| Provider Name | Jean M Richman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386949097 PECOS PAC ID: 8426216623 Enrollment ID: I20120220000437 |
| Provider Name | David D Wines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457368383 PECOS PAC ID: 6305008426 Enrollment ID: I20120507000117 |
| Provider Name | Katen S Park |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346396553 PECOS PAC ID: 0840275053 Enrollment ID: I20120531000142 |
| Provider Name | Michele A Virva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003187584 PECOS PAC ID: 0244495653 Enrollment ID: I20120710000768 |
| Provider Name | Marilyn R Mclane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396902961 PECOS PAC ID: 3870759152 Enrollment ID: I20120801000261 |
| Provider Name | Huri A Kushner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316229941 PECOS PAC ID: 4284882903 Enrollment ID: I20120921000707 |
| Provider Name | Rajasekhar Jupalli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760557326 PECOS PAC ID: 9032356829 Enrollment ID: I20130515000428 |
| Provider Name | Belal Hegazy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205103793 PECOS PAC ID: 5092956409 Enrollment ID: I20130729000123 |
| Provider Name | Sandra A Bronsberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912277476 PECOS PAC ID: 7517191463 Enrollment ID: I20131008000334 |
| Provider Name | Abby J Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831326248 PECOS PAC ID: 4486880960 Enrollment ID: I20131112001685 |
| Provider Name | Deloris Curry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114212339 PECOS PAC ID: 5991932097 Enrollment ID: I20131217001339 |
| Provider Name | Bradley Klemm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932225570 PECOS PAC ID: 5597993832 Enrollment ID: I20140114000862 |
| Provider Name | Dinah Mary Weststrate |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871928358 PECOS PAC ID: 7810125929 Enrollment ID: I20140117001581 |
| Provider Name | Amy M Culbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538363387 PECOS PAC ID: 0244461457 Enrollment ID: I20140331001861 |
| Provider Name | Michael Paul-david Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174721997 PECOS PAC ID: 7517182629 Enrollment ID: I20140703001678 |
| Provider Name | Matthew Alexander Solit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720495567 PECOS PAC ID: 8224254578 Enrollment ID: I20140924002148 |
| Provider Name | Meghan Faust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851729354 PECOS PAC ID: 9830319870 Enrollment ID: I20140925001530 |
| Provider Name | Don Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528155850 PECOS PAC ID: 9638136799 Enrollment ID: I20141015001981 |
| Provider Name | Mary Eldredge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497147532 PECOS PAC ID: 9739406349 Enrollment ID: I20150319000877 |
| Provider Name | Carly Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396160503 PECOS PAC ID: 9739408584 Enrollment ID: I20150429002286 |
| Provider Name | Denise D Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124407937 PECOS PAC ID: 7618288770 Enrollment ID: I20150617000100 |
| Provider Name | Tonya M Lake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952706236 PECOS PAC ID: 8325359086 Enrollment ID: I20150622001714 |
| Provider Name | Iyantta S Howell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750545075 PECOS PAC ID: 1759608904 Enrollment ID: I20150812006379 |
| Provider Name | Krystle Charon-woods Hollier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316336506 PECOS PAC ID: 6305155052 Enrollment ID: I20151020000173 |
| Provider Name | Marcia Davenport Kent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912002155 PECOS PAC ID: 0042209660 Enrollment ID: I20151221001496 |
| Provider Name | Anne Marie Fano Arevalo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922486729 PECOS PAC ID: 6507160975 Enrollment ID: I20160204001137 |
| Provider Name | Chinwe Prisca Ohaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700226875 PECOS PAC ID: 9436453685 Enrollment ID: I20160208001937 |
| Provider Name | Kamera S Boggon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700247772 PECOS PAC ID: 2769772995 Enrollment ID: I20160531002509 |
| Provider Name | Brenda Sue Obrien |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1154351773 PECOS PAC ID: 2567753940 Enrollment ID: I20160614002622 |
| Provider Name | Matthew J Radler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972867034 PECOS PAC ID: 3476783903 Enrollment ID: I20160719002288 |
| Provider Name | Christina D Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750732822 PECOS PAC ID: 3072808310 Enrollment ID: I20160825000273 |
| Provider Name | Nasreen R Meah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811348238 PECOS PAC ID: 7618258096 Enrollment ID: I20161222000820 |
| Provider Name | Lindsay R Dunstan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649497850 PECOS PAC ID: 8123309424 Enrollment ID: I20161228001636 |
| Provider Name | Karla Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518403153 PECOS PAC ID: 9032494000 Enrollment ID: I20170315000362 |
| Provider Name | Jessie Maynard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710126750 PECOS PAC ID: 3072899244 Enrollment ID: I20170425000701 |
| Provider Name | Sameera Ahmed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649332552 PECOS PAC ID: 5496032070 Enrollment ID: I20170509000604 |
| Provider Name | Jana M Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013439827 PECOS PAC ID: 3375813074 Enrollment ID: I20170727002274 |
| Provider Name | Jessica L Wentworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336591973 PECOS PAC ID: 9931471877 Enrollment ID: I20170828000871 |
| Provider Name | Mary A Hillier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427586965 PECOS PAC ID: 9830463751 Enrollment ID: I20170915001840 |
| Provider Name | Lashonda K Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447670427 PECOS PAC ID: 8325312986 Enrollment ID: I20170920001190 |
| Provider Name | Clarissa N Gayer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932336948 PECOS PAC ID: 0446518682 Enrollment ID: I20171218001939 |
| Provider Name | Katherine S Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912419110 PECOS PAC ID: 7618237801 Enrollment ID: I20180208000785 |
| Provider Name | Mary Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538606074 PECOS PAC ID: 9830450386 Enrollment ID: I20180227000242 |
| Provider Name | Stephanie Y Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912414756 PECOS PAC ID: 7911260484 Enrollment ID: I20180416000184 |
| Provider Name | Tobi A Moreno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881199552 PECOS PAC ID: 1850654294 Enrollment ID: I20180417001081 |
| Provider Name | Derrick Freyman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922510940 PECOS PAC ID: 8527316702 Enrollment ID: I20180803001277 |
| Provider Name | Ashley Punches |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396255352 PECOS PAC ID: 5597027862 Enrollment ID: I20181009001730 |
| Provider Name | Necole Nyree Jamison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346592938 PECOS PAC ID: 9335485929 Enrollment ID: I20190118001861 |
| Provider Name | Laurie J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730526849 PECOS PAC ID: 7416294186 Enrollment ID: I20190204001525 |
| Provider Name | Rosario Tanguay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063986479 PECOS PAC ID: 5799026209 Enrollment ID: I20190410002473 |
| Provider Name | Brittney F Briggs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548695604 PECOS PAC ID: 8123360609 Enrollment ID: I20190502001517 |
| Provider Name | Melissa Sue Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316405996 PECOS PAC ID: 7012259591 Enrollment ID: I20190502001586 |
| Provider Name | Lisa A Martinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649421959 PECOS PAC ID: 9537401815 Enrollment ID: I20190507002475 |
| Provider Name | Tatyana Fleysher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114285392 PECOS PAC ID: 0941548507 Enrollment ID: I20190520000017 |
| Provider Name | Stacey Lyn Molinaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497220917 PECOS PAC ID: 0648513960 Enrollment ID: I20190529002428 |
| Provider Name | Beth Sharlow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689634560 PECOS PAC ID: 7113149394 Enrollment ID: I20190703002870 |
| Provider Name | Sara Ziel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225570690 PECOS PAC ID: 1850620337 Enrollment ID: I20190909002303 |
| Provider Name | Sarah Ellen Deleon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114304342 PECOS PAC ID: 1557663051 Enrollment ID: I20190912000616 |
| Provider Name | Stefanie Ann Sabin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629320684 PECOS PAC ID: 1052640133 Enrollment ID: I20190916001437 |
| Provider Name | Susan M Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013564343 PECOS PAC ID: 1951631837 Enrollment ID: I20190918002932 |
| Provider Name | Adam P Walters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619527140 PECOS PAC ID: 8426388588 Enrollment ID: I20191002003844 |
| Provider Name | Megan Suzanne Hogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700433737 PECOS PAC ID: 4981935095 Enrollment ID: I20191003001914 |
| Provider Name | Michael Samar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245663301 PECOS PAC ID: 8224360482 Enrollment ID: I20191022000360 |
| Provider Name | Lynn Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255710059 PECOS PAC ID: 8820420250 Enrollment ID: I20191122001530 |
| Provider Name | Raji S George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831758689 PECOS PAC ID: 8820422413 Enrollment ID: I20200108000512 |
| Provider Name | Patricia Anne Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215302872 PECOS PAC ID: 5890030399 Enrollment ID: I20200224002468 |
| Provider Name | Jillian R Peyerk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700370707 PECOS PAC ID: 3072940048 Enrollment ID: I20200304000895 |
| Provider Name | Tammy Lynn Ruterbusch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083174932 PECOS PAC ID: 2860829728 Enrollment ID: I20200305001770 |
| Provider Name | Kelsey A Thelen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447899745 PECOS PAC ID: 9234567173 Enrollment ID: I20200309000054 |
| Provider Name | Jakie L Conachan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942844568 PECOS PAC ID: 0941638662 Enrollment ID: I20200311002367 |
| Provider Name | Crystal Kania |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710432471 PECOS PAC ID: 9931537594 Enrollment ID: I20200312001579 |
| Provider Name | Joyce L Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083059141 PECOS PAC ID: 2567891203 Enrollment ID: I20200401002149 |
| Provider Name | Molly Bato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437600251 PECOS PAC ID: 6103255500 Enrollment ID: I20200407000263 |
| Provider Name | Jazmin Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053712265 PECOS PAC ID: 1254606486 Enrollment ID: I20200419000054 |
| Provider Name | Ryan Upson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891032439 PECOS PAC ID: 1759711963 Enrollment ID: I20200430000296 |
| Provider Name | Luke Marsy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740759364 PECOS PAC ID: 4183046055 Enrollment ID: I20200623000454 |
| Provider Name | Shell Freeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093199713 PECOS PAC ID: 2163840992 Enrollment ID: I20200910003128 |
| Provider Name | Brittany Radler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992321830 PECOS PAC ID: 0446679344 Enrollment ID: I20200925001735 |
| Provider Name | Karissa Lynne Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740888429 PECOS PAC ID: 4789004219 Enrollment ID: I20201021002009 |
| Provider Name | Memphis Sandoval |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720692494 PECOS PAC ID: 5799195657 Enrollment ID: I20201104000128 |
| Provider Name | Carl Huntoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649883653 PECOS PAC ID: 5799195665 Enrollment ID: I20201104000493 |
| Provider Name | Mary-devon Leigh Bement |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295246031 PECOS PAC ID: 7214348689 Enrollment ID: I20201117000429 |
| Provider Name | Joseph Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104155126 PECOS PAC ID: 6507278488 Enrollment ID: I20201217001816 |
| Provider Name | Linda A Schoonover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154917946 PECOS PAC ID: 8628115581 Enrollment ID: I20210121000579 |
| Provider Name | Audrey Lee Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093237943 PECOS PAC ID: 6204240427 Enrollment ID: I20210129002230 |
| Provider Name | Lonneisha Rutherford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700237526 PECOS PAC ID: 2264846344 Enrollment ID: I20210201002273 |
| Provider Name | Saniyah Shahid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982015269 PECOS PAC ID: 8325453178 Enrollment ID: I20210209001894 |
| Provider Name | Stacy Nicole Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144710773 PECOS PAC ID: 8527474311 Enrollment ID: I20210302001771 |
| Provider Name | Toccara E Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568813871 PECOS PAC ID: 5496162372 Enrollment ID: I20210319000890 |
| Provider Name | Carolyn T Roath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487060869 PECOS PAC ID: 5294142063 Enrollment ID: I20210323000114 |
| Provider Name | William Franklin-cromwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346728003 PECOS PAC ID: 1052720034 Enrollment ID: I20210503002573 |
| Provider Name | Sarah Woodward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255840047 PECOS PAC ID: 4385043843 Enrollment ID: I20210603000993 |
| Provider Name | Nicola Claire Herman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215502091 PECOS PAC ID: 6002216371 Enrollment ID: I20210609000823 |
| Provider Name | Lara Pomnitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568955128 PECOS PAC ID: 0749680809 Enrollment ID: I20210610001537 |
| Provider Name | Theodora Chukwudi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063005403 PECOS PAC ID: 5890961742 Enrollment ID: I20210623002718 |
| Provider Name | Trinity Starr Collins-justian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942339247 PECOS PAC ID: 7911300595 Enrollment ID: I20210720001352 |
| Provider Name | Liam Blakian Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801465034 PECOS PAC ID: 1153724299 Enrollment ID: I20210727000972 |
| Provider Name | Lisa M Rae |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053980326 PECOS PAC ID: 1850795469 Enrollment ID: I20210804001625 |
| Provider Name | Celia M Dunn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346913605 PECOS PAC ID: 6103220694 Enrollment ID: I20210805000772 |
| Provider Name | Joni Shinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104305549 PECOS PAC ID: 6406250687 Enrollment ID: I20210810003110 |
| Provider Name | Tracey Darling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487080099 PECOS PAC ID: 4385040344 Enrollment ID: I20210831002000 |
| Provider Name | Melissa Lininger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700453149 PECOS PAC ID: 0143626754 Enrollment ID: I20210908000398 |
| Provider Name | Natasha Helena Sprau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578042560 PECOS PAC ID: 7315344090 Enrollment ID: I20210922002858 |
| Provider Name | Julie Decoste |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205369675 PECOS PAC ID: 7113325598 Enrollment ID: I20211015000933 |
| Provider Name | Ashley Kniceley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356617203 PECOS PAC ID: 9537557293 Enrollment ID: I20211028002769 |
| Provider Name | Amy Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306403407 PECOS PAC ID: 2264820794 Enrollment ID: I20211102001470 |
| Provider Name | Karen Marie Harasymiw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528723616 PECOS PAC ID: 7012307234 Enrollment ID: I20211202001259 |
| Provider Name | Krystine Marie Muha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841870235 PECOS PAC ID: 9739570102 Enrollment ID: I20211217001822 |
| Provider Name | Samantha Amber Benson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457723348 PECOS PAC ID: 1850782145 Enrollment ID: I20211221001335 |
| Provider Name | Dominic Misiak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164982328 PECOS PAC ID: 6709117013 Enrollment ID: I20220113000617 |
| Provider Name | Maxwell Francis Chisholm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801313119 PECOS PAC ID: 8527450485 Enrollment ID: I20220126002623 |
| Provider Name | Kryn L Sisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245296326 PECOS PAC ID: 2769875368 Enrollment ID: I20220203000156 |
| Provider Name | Jamie Morant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497245435 PECOS PAC ID: 4587057799 Enrollment ID: I20220211000628 |
| Provider Name | Curtis Leipold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801552336 PECOS PAC ID: 4385038637 Enrollment ID: I20220302001243 |
| Provider Name | Keith Mosa-basha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518433895 PECOS PAC ID: 7012301088 Enrollment ID: I20220308002863 |
| Provider Name | Eban James Mackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558028027 PECOS PAC ID: 4183010580 Enrollment ID: I20220412002466 |
| Provider Name | Amanda Carr |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679764609 PECOS PAC ID: 2769889419 Enrollment ID: I20220418000271 |
| Provider Name | Maria Danica San Juan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235760448 PECOS PAC ID: 4486041498 Enrollment ID: I20220421001154 |
| Provider Name | Emily Lynn Brundage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881102994 PECOS PAC ID: 6709273337 Enrollment ID: I20220428000851 |
| Provider Name | Bushra Haneef Qureishi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396969416 PECOS PAC ID: 9537251087 Enrollment ID: I20220504000168 |
| Provider Name | Akeyia Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619422169 PECOS PAC ID: 4981091360 Enrollment ID: I20220504000968 |
| Provider Name | Deanna Janel Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306587795 PECOS PAC ID: 4385021633 Enrollment ID: I20220506001773 |
| Provider Name | Chiqutta Crook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962162974 PECOS PAC ID: 6608253836 Enrollment ID: I20220510000399 |
| Provider Name | Ruthann Amanda Lapham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588310585 PECOS PAC ID: 0244617876 Enrollment ID: I20220519001324 |
| Provider Name | Israil Steen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487127056 PECOS PAC ID: 6709264922 Enrollment ID: I20220531002296 |
| Provider Name | Zain Sattar Choudhry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063901171 PECOS PAC ID: 5991183808 Enrollment ID: I20220606002067 |
| Provider Name | Jemila A Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417626771 PECOS PAC ID: 1254719958 Enrollment ID: I20220609000215 |
| Provider Name | Lori Sue Dilorenzo |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1346310687 PECOS PAC ID: 6406938604 Enrollment ID: I20220610001306 |
| Provider Name | Rohan Praveen Kedar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154828036 PECOS PAC ID: 6002162120 Enrollment ID: I20220623000170 |
| Provider Name | Curtis Norwick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689179970 PECOS PAC ID: 2264788389 Enrollment ID: I20220623000633 |
| Provider Name | Nicole Lynn Vasher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508468257 PECOS PAC ID: 0749669398 Enrollment ID: I20220628001658 |
| Provider Name | Angela Elaine Smedo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598250698 PECOS PAC ID: 1355721093 Enrollment ID: I20220712001001 |
| Provider Name | Samantha Dunning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649827817 PECOS PAC ID: 2567843139 Enrollment ID: I20220714001252 |
| Provider Name | Sara Anne Minadeo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184363541 PECOS PAC ID: 2264813443 Enrollment ID: I20220719002747 |
| Provider Name | Dawn M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255679890 PECOS PAC ID: 3173905189 Enrollment ID: I20220806000352 |
| Provider Name | Luann Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730814534 PECOS PAC ID: 3476937392 Enrollment ID: I20220826000366 |
| Provider Name | Mfon Essien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275276750 PECOS PAC ID: 7911381868 Enrollment ID: I20220826001772 |
| Provider Name | Chiamaka Uzoma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720712052 PECOS PAC ID: 0244614592 Enrollment ID: I20220906000672 |
| Provider Name | Ekuevugbe Priscillia Onosode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417684580 PECOS PAC ID: 2860876042 Enrollment ID: I20220907002965 |
| Provider Name | John Devivo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205175791 PECOS PAC ID: 8123308293 Enrollment ID: I20220908001384 |
| Provider Name | Nathan Neal Perry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356908651 PECOS PAC ID: 5092181115 Enrollment ID: I20221014001015 |
| Provider Name | Brittany Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396355152 PECOS PAC ID: 3678949468 Enrollment ID: I20221019001846 |
| Provider Name | Angela Arlene Goodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518501089 PECOS PAC ID: 4981071206 Enrollment ID: I20221029000307 |
| Provider Name | Christopher J Genther |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427792175 PECOS PAC ID: 5395113484 Enrollment ID: I20221121002475 |
| Provider Name | Gloria Egeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770219735 PECOS PAC ID: 5496124083 Enrollment ID: I20221202001067 |
| Provider Name | Marissa Leeann Havard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124738182 PECOS PAC ID: 2264801471 Enrollment ID: I20221210000316 |
| Provider Name | Michelle Elizabeth Yordi Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194224899 PECOS PAC ID: 6901275833 Enrollment ID: I20221215000108 |
| Provider Name | Angelina Brooke Perkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285345207 PECOS PAC ID: 2062881873 Enrollment ID: I20221216000782 |
| Provider Name | Ryan Crochran Rollins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851811285 PECOS PAC ID: 5799155321 Enrollment ID: I20221223000156 |
| Provider Name | Paula Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619120755 PECOS PAC ID: 5698831519 Enrollment ID: I20221228002227 |
| Provider Name | Jeffrey Veldman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487370268 PECOS PAC ID: 5890166789 Enrollment ID: I20230201001931 |
| Provider Name | Inez Brooks Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598981680 PECOS PAC ID: 4587036918 Enrollment ID: I20230214000601 |
| Provider Name | Nicole L Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750706826 PECOS PAC ID: 2062885890 Enrollment ID: I20230227001379 |
| Provider Name | Spring Lenette Grimes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275609695 PECOS PAC ID: 0345613626 Enrollment ID: I20230307003117 |
| Provider Name | Suzanne Marie Lugger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114536232 PECOS PAC ID: 6608249818 Enrollment ID: I20230308001257 |
| Provider Name | Elizabeth Kahari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063112191 PECOS PAC ID: 6608240783 Enrollment ID: I20230314000769 |
| Provider Name | Gabrielle Mcdaniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841643251 PECOS PAC ID: 1658745468 Enrollment ID: I20230317001713 |
| Provider Name | Gurjeet Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851068829 PECOS PAC ID: 1759755390 Enrollment ID: I20230321002419 |
| Provider Name | Jessica Boss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609235621 PECOS PAC ID: 7517332760 Enrollment ID: I20230331001769 |
| Provider Name | Chelsea Elizabeth Litwiller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497303986 PECOS PAC ID: 8426423351 Enrollment ID: I20230407000102 |
| Provider Name | Sara Elmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417657958 PECOS PAC ID: 7810362308 Enrollment ID: I20230414001961 |
| Provider Name | Karrin Burnadette Boylston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194411702 PECOS PAC ID: 0143685826 Enrollment ID: I20230502002671 |
| Provider Name | William Schaefer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588200240 PECOS PAC ID: 3072978527 Enrollment ID: I20230505000527 |
| Provider Name | Lisa Catherine Gates |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073176079 PECOS PAC ID: 4183089659 Enrollment ID: I20230505001384 |
| Provider Name | Diana Nicole Schein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275003006 PECOS PAC ID: 1850757543 Enrollment ID: I20230523001341 |
| Provider Name | Wynter Joi Wyrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255587374 PECOS PAC ID: 2365808854 Enrollment ID: I20230526000119 |
| Provider Name | Rosemarie Villarreal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376083246 PECOS PAC ID: 0446618086 Enrollment ID: I20230614001579 |
| Provider Name | Emily Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598359432 PECOS PAC ID: 4789042516 Enrollment ID: I20230626003012 |
| Provider Name | Colleen Crossey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235864273 PECOS PAC ID: 2769841378 Enrollment ID: I20230629002548 |
| Provider Name | Candice Slizewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710540372 PECOS PAC ID: 6709245277 Enrollment ID: I20230630000381 |
| Provider Name | Ericka Magee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104468255 PECOS PAC ID: 2860851953 Enrollment ID: I20230707001346 |
| Provider Name | Paola Paquini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245920669 PECOS PAC ID: 0941660740 Enrollment ID: I20230712000660 |
| Provider Name | Gladys O Kuik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386334167 PECOS PAC ID: 1658731161 Enrollment ID: I20230715000556 |
| Provider Name | Amanda Maluchnik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992159024 PECOS PAC ID: 9335500859 Enrollment ID: I20230801001194 |
| Provider Name | Sarah Brittany Bauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821652629 PECOS PAC ID: 7315308582 Enrollment ID: I20230803003527 |
| Provider Name | Chelsea Kristine Owens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699309328 PECOS PAC ID: 1355704099 Enrollment ID: I20230829003214 |
| Provider Name | Robyn Lee Siegel-hinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295990927 PECOS PAC ID: 6608220702 Enrollment ID: I20230922002568 |
| Provider Name | Diann Therese Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336183540 PECOS PAC ID: 8729090345 Enrollment ID: I20230922003657 |
| Provider Name | Amanda Elizabeth Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295511020 PECOS PAC ID: 1456706712 Enrollment ID: I20231006002244 |
| Provider Name | Jodie Lynn Haber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942589163 PECOS PAC ID: 1456707173 Enrollment ID: I20231031003082 |
| Provider Name | Alexandra J Colvard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548394463 PECOS PAC ID: 7618325333 Enrollment ID: I20231118000145 |
| Provider Name | Davida Pace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356587265 PECOS PAC ID: 9133577851 Enrollment ID: I20231118000283 |
| Provider Name | Julie A Stephenson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508231747 PECOS PAC ID: 1557719283 Enrollment ID: I20231118000477 |
| Provider Name | Kellie Ann Puro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336273861 PECOS PAC ID: 8224486964 Enrollment ID: I20231120000284 |
| Provider Name | Karyn Louise Lock-bryne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386015378 PECOS PAC ID: 4385092030 Enrollment ID: I20231120000495 |
| Provider Name | Patricia Ann Palmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306110788 PECOS PAC ID: 1254789902 Enrollment ID: I20231120000584 |
| Provider Name | Susan Camille Muinch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629263140 PECOS PAC ID: 0941658629 Enrollment ID: I20231120001679 |
| Provider Name | Lamika Monicque Harper-shelton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427178326 PECOS PAC ID: 1355799032 Enrollment ID: I20231120001870 |
| Provider Name | Jennifer Elizabeth Arkwright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053438580 PECOS PAC ID: 0345698932 Enrollment ID: I20231120002470 |
| Provider Name | Courtney Leigh Yost |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255000832 PECOS PAC ID: 3072961556 Enrollment ID: I20231121003127 |
| Provider Name | Marylynn Gronow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740641497 PECOS PAC ID: 1759739246 Enrollment ID: I20231121003766 |
| Provider Name | Karen A Bailey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447503834 PECOS PAC ID: 2567810096 Enrollment ID: I20231122000967 |
| Provider Name | Maria Del Carmen Lizcano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356808570 PECOS PAC ID: 3375991805 Enrollment ID: I20231122001033 |
| Provider Name | Daren M Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770854069 PECOS PAC ID: 8426406984 Enrollment ID: I20231122002015 |
| Provider Name | Kathleen Roberson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467831834 PECOS PAC ID: 5496103954 Enrollment ID: I20231122002146 |
| Provider Name | Venus Louise Sage |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023124427 PECOS PAC ID: 6507214947 Enrollment ID: I20231127000944 |
| Provider Name | Colton Darrow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467942805 PECOS PAC ID: 1850749110 Enrollment ID: I20231127002179 |
| Provider Name | Antony Benjamin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588015119 PECOS PAC ID: 4284082553 Enrollment ID: I20231127002299 |
| Provider Name | Yvonne Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831475680 PECOS PAC ID: 9537517800 Enrollment ID: I20231127002340 |
| Provider Name | Robert Tom Rollis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710158308 PECOS PAC ID: 9739537044 Enrollment ID: I20231128000648 |
| Provider Name | Holly Morris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578096848 PECOS PAC ID: 8628426947 Enrollment ID: I20231128001142 |
| Provider Name | Mark Alan Deering |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457825721 PECOS PAC ID: 9739537069 Enrollment ID: I20231128001506 |
| Provider Name | Renee D Shaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699809194 PECOS PAC ID: 5890031728 Enrollment ID: I20231128002851 |
| Provider Name | Della April Rees |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396363073 PECOS PAC ID: 5294183463 Enrollment ID: I20231128003214 |
| Provider Name | Marah Leonie Mischakoff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821277088 PECOS PAC ID: 7315395589 Enrollment ID: I20231128003539 |
| Provider Name | Jamie Castillo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205214293 PECOS PAC ID: 7012365208 Enrollment ID: I20231129000209 |
| Provider Name | Heidi R. Freeman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386233609 PECOS PAC ID: 3779931977 Enrollment ID: I20231129000532 |
| Provider Name | Jennifer Mercer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275958902 PECOS PAC ID: 2365890563 Enrollment ID: I20231129000710 |
| Provider Name | Krystal Lynn Rau |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932677283 PECOS PAC ID: 2961850169 Enrollment ID: I20231129000825 |
| Provider Name | Denise M Urban |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477749174 PECOS PAC ID: 0547618779 Enrollment ID: I20231129001973 |
| Provider Name | Rachel Dara Robbins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578222097 PECOS PAC ID: 0244688307 Enrollment ID: I20231129003485 |
| Provider Name | Heather A Medrano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326470444 PECOS PAC ID: 6800244989 Enrollment ID: I20231130000231 |
| Provider Name | Ronda Shorter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467234179 PECOS PAC ID: 2769830868 Enrollment ID: I20231130000822 |
| Provider Name | Edward Albert Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487141115 PECOS PAC ID: 9133577240 Enrollment ID: I20231130001222 |
| Provider Name | Holly Rhode |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427609023 PECOS PAC ID: 1153779277 Enrollment ID: I20231130001546 |
| Provider Name | Alicia M Watt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811248974 PECOS PAC ID: 0042668071 Enrollment ID: I20231130002617 |
| Provider Name | Ashley Rae Losher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730746389 PECOS PAC ID: 7911356480 Enrollment ID: I20231208001866 |
| Provider Name | Jenna Rae Gepper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942679923 PECOS PAC ID: 2365891843 Enrollment ID: I20231208001964 |
| Provider Name | Stephanie Denise Wilson Hegle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558912394 PECOS PAC ID: 0648629147 Enrollment ID: I20231208002784 |
| Provider Name | Michelle Fitzhugh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033861992 PECOS PAC ID: 6002265220 Enrollment ID: I20231213003812 |
| Provider Name | Deborah Rose Kalfayan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770792988 PECOS PAC ID: 4587013537 Enrollment ID: I20231215001381 |
| Provider Name | Janice Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770251217 PECOS PAC ID: 8628428448 Enrollment ID: I20231220000825 |
| Provider Name | Ian Bewick Goldsbrough |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750894515 PECOS PAC ID: 3577913300 Enrollment ID: I20231220001090 |
| Provider Name | Terri Lynn Rose |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487264529 PECOS PAC ID: 1052761814 Enrollment ID: I20231220002284 |
| Provider Name | Angela Denise Diallo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578962098 PECOS PAC ID: 1759731466 Enrollment ID: I20231221000353 |
| Provider Name | Heidi L Dygert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740604438 PECOS PAC ID: 0840640934 Enrollment ID: I20240102003179 |
| Provider Name | Alaina Knoedler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164943122 PECOS PAC ID: 2365893153 Enrollment ID: I20240105001232 |
| Provider Name | Kirby E Brash |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710428099 PECOS PAC ID: 3678924263 Enrollment ID: I20240108005672 |
| Provider Name | Kate Szubeczak Mckee |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679829436 PECOS PAC ID: 9234580481 Enrollment ID: I20240111003836 |
| Provider Name | Marc Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871258178 PECOS PAC ID: 7416309638 Enrollment ID: I20240123003211 |
| Provider Name | Jamie L Mallon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629580782 PECOS PAC ID: 6002269834 Enrollment ID: I20240129002719 |
| Provider Name | Megan Powers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538527981 PECOS PAC ID: 5496171720 Enrollment ID: I20240207001977 |
| Provider Name | Melanie Krieg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518263664 PECOS PAC ID: 4183068745 Enrollment ID: I20240222000995 |
| Provider Name | Katherine Ajluni Eilers |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811422009 PECOS PAC ID: 0648615229 Enrollment ID: I20240305003618 |
| Provider Name | Chidimma Ozor Commer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285302075 PECOS PAC ID: 9133565716 Enrollment ID: I20240306002658 |
| Provider Name | Demi Anne Devenny |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154073781 PECOS PAC ID: 2466899844 Enrollment ID: I20240320003559 |
| Provider Name | Jerry Michael Nehr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316376726 PECOS PAC ID: 9739526997 Enrollment ID: I20240322002959 |
| Provider Name | Anne C Mcinnis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740356740 PECOS PAC ID: 4789686635 Enrollment ID: I20240322003212 |
| Provider Name | Brandy Nechelle Pope |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962838557 PECOS PAC ID: 0941647143 Enrollment ID: I20240323000391 |
| Provider Name | Brenda Jean Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659938298 PECOS PAC ID: 7911344122 Enrollment ID: I20240325000128 |
| Provider Name | Megan Elizabeth Sheeran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114780863 PECOS PAC ID: 9830536051 Enrollment ID: I20240325000479 |
| Provider Name | Howard David Gofstein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851430458 PECOS PAC ID: 8123466430 Enrollment ID: I20240405001272 |
| Provider Name | Erica D Shifflet-chila |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891383576 PECOS PAC ID: 5698114064 Enrollment ID: I20240417004289 |
| Provider Name | Damon Delano Chambers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083246573 PECOS PAC ID: 0547609869 Enrollment ID: I20240419001561 |
| Provider Name | Janelle Kaprice Logan Wilkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538929344 PECOS PAC ID: 4981043023 Enrollment ID: I20240422002527 |
| Provider Name | Daniel Joseph Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134814940 PECOS PAC ID: 4284073206 Enrollment ID: I20240423002554 |
| Provider Name | Zeinab Abdulnabi Hourani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083184204 PECOS PAC ID: 3678912631 Enrollment ID: I20240423004248 |
| Provider Name | Steven Michael Powers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982751665 PECOS PAC ID: 4486093440 Enrollment ID: I20240423004304 |
| Provider Name | Deborah Lane Mears |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902113954 PECOS PAC ID: 7810337813 Enrollment ID: I20240424001435 |
| Provider Name | Lakita Snead |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851028716 PECOS PAC ID: 4789024787 Enrollment ID: I20240424001626 |
| Provider Name | Serena A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457026247 PECOS PAC ID: 9335589076 Enrollment ID: I20240429003038 |
| Provider Name | Laura Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629737432 PECOS PAC ID: 6305286923 Enrollment ID: I20240430002771 |
| Provider Name | Kenitra L. Webster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538914692 PECOS PAC ID: 1456791615 Enrollment ID: I20240504000311 |
| Provider Name | Sasha Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922355387 PECOS PAC ID: 1254772056 Enrollment ID: I20240510001603 |
| Provider Name | Jason P Sheppard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659984326 PECOS PAC ID: 2769823566 Enrollment ID: I20240510001782 |
| Provider Name | Kelsy D Hoerauf |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1235430802 PECOS PAC ID: 9739520933 Enrollment ID: I20240517002227 |
| Provider Name | Anthony Opara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346002409 PECOS PAC ID: 1759722903 Enrollment ID: I20240518000156 |
| Provider Name | Andrea Hiyam Naaum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487071809 PECOS PAC ID: 0143510248 Enrollment ID: I20240613003386 |
| Provider Name | Jennifer Mcconnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649752742 PECOS PAC ID: 9537602602 Enrollment ID: I20240617003432 |
| Provider Name | Tamiko Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558007443 PECOS PAC ID: 8527501659 Enrollment ID: I20240618001697 |
| Provider Name | Breanna Christine Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912567868 PECOS PAC ID: 2466995436 Enrollment ID: I20240618003306 |
| Provider Name | Jamie Boivin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427408756 PECOS PAC ID: 1557806890 Enrollment ID: I20240711001430 |
| Provider Name | Monique Angelica Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467571752 PECOS PAC ID: 8527018985 Enrollment ID: I20240723000561 |
| Provider Name | Delisha Isabell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093352049 PECOS PAC ID: 7810433091 Enrollment ID: I20240724001149 |
| Provider Name | Shelby Hope |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417583378 PECOS PAC ID: 6901229012 Enrollment ID: I20240724003804 |
| Provider Name | Shannon Roehm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104376250 PECOS PAC ID: 3971040452 Enrollment ID: I20240801002250 |
| Provider Name | James Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376276535 PECOS PAC ID: 0547707879 Enrollment ID: I20240805003292 |
| Provider Name | Jacqueline Boboescu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184466229 PECOS PAC ID: 8123565355 Enrollment ID: I20240805003604 |
| Provider Name | Jordyn Taylor Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952811812 PECOS PAC ID: 3173920642 Enrollment ID: I20240813000576 |
| Provider Name | Holly Ann Hart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568944767 PECOS PAC ID: 4587102249 Enrollment ID: I20240813004181 |
| Provider Name | Amanda Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467845271 PECOS PAC ID: 2567901010 Enrollment ID: I20240828001470 |
| Provider Name | Tracy Regina Purnell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841420213 PECOS PAC ID: 7618418682 Enrollment ID: I20240917004185 |
| Provider Name | Krista Marie Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194403410 PECOS PAC ID: 3870027311 Enrollment ID: I20241106004018 |
| Provider Name | Felicia Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003203308 PECOS PAC ID: 6709311426 Enrollment ID: I20241119000174 |
| Provider Name | Laveta J Roberson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780316299 PECOS PAC ID: 0648653725 Enrollment ID: I20241203003315 |
| Provider Name | Donovan Khamoro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275205429 PECOS PAC ID: 2365978889 Enrollment ID: I20241207000171 |
| Provider Name | Jill Hanna Wasserman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902156888 PECOS PAC ID: 3870029044 Enrollment ID: I20241211001826 |
| Provider Name | Rozana Jean Kelly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154763480 PECOS PAC ID: 7012443088 Enrollment ID: I20241213001780 |
| Provider Name | Jennifer Louise Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356190128 PECOS PAC ID: 0648707455 Enrollment ID: I20241218000547 |
| Provider Name | Christine Leadbetter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629746235 PECOS PAC ID: 9032646708 Enrollment ID: I20241218003772 |
| Provider Name | Peter Albert Girz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770827701 PECOS PAC ID: 1850828575 Enrollment ID: I20241219001211 |
| Provider Name | Lisa Kotula |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639912298 PECOS PAC ID: 0749717312 Enrollment ID: I20241219004112 |
| Provider Name | Caitlyn Thelen Bischoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154144913 PECOS PAC ID: 9739616780 Enrollment ID: I20250102002514 |
| Provider Name | Kim Denise Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609380997 PECOS PAC ID: 3274062013 Enrollment ID: I20250123003705 |
| Provider Name | Tricia Louise Wilder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336971878 PECOS PAC ID: 7810426319 Enrollment ID: I20250129001167 |
| Provider Name | Brittany Kozlowicz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104484468 PECOS PAC ID: 4587193008 Enrollment ID: I20250129001882 |
| Provider Name | Kerri Michelle Kenel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407920432 PECOS PAC ID: 7618406026 Enrollment ID: I20250130001732 |
| Provider Name | Quinn Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558835025 PECOS PAC ID: 0446780613 Enrollment ID: I20250204002119 |
| Provider Name | Ijeoma Oranefo-okoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043037500 PECOS PAC ID: 2668902503 Enrollment ID: I20250207001530 |
| Provider Name | Sarah R Tomcala |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053752048 PECOS PAC ID: 9830629583 Enrollment ID: I20250210003221 |
| Provider Name | Stacy Kontur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669848024 PECOS PAC ID: 3375063316 Enrollment ID: I20250221000207 |
| Provider Name | Madisen Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245919869 PECOS PAC ID: 8224473871 Enrollment ID: I20250224002185 |
| Provider Name | Amanda Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942759899 PECOS PAC ID: 1254851603 Enrollment ID: I20250228000678 |
| Provider Name | Joshua Michael Ayers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639824394 PECOS PAC ID: 9335660208 Enrollment ID: I20250307000998 |
| Provider Name | Nicole Leanna Schmelz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417775826 PECOS PAC ID: 4385166917 Enrollment ID: I20250324001403 |
| Provider Name | Brian James Nassar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740409697 PECOS PAC ID: 8123418886 Enrollment ID: I20250327001967 |
| Provider Name | Christina Henderson-bassett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104355288 PECOS PAC ID: 8426451535 Enrollment ID: I20250401000671 |
| Provider Name | Allison Sue Glickman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114471638 PECOS PAC ID: 5890218762 Enrollment ID: I20250401002319 |
| Provider Name | Jeremy Force-smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558133322 PECOS PAC ID: 5395268015 Enrollment ID: I20250402003009 |
| Provider Name | Michelle Monforton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396158960 PECOS PAC ID: 9032632724 Enrollment ID: I20250403000775 |
| Provider Name | Jayla C Caver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811468275 PECOS PAC ID: 6507380482 Enrollment ID: I20250412000289 |
| Provider Name | Emily Anne Schott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548794407 PECOS PAC ID: 2466979471 Enrollment ID: I20250502002252 |
| Provider Name | Jennifer Rosemarie Foskett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407518483 PECOS PAC ID: 2365960432 Enrollment ID: I20250513003142 |
| Provider Name | Gordon Grant Garris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821821521 PECOS PAC ID: 0345769543 Enrollment ID: I20250521000944 |
| Provider Name | Nadine Atoui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598345860 PECOS PAC ID: 2769901842 Enrollment ID: I20250521003068 |
| Provider Name | Shaly M Penrod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568196251 PECOS PAC ID: 5799294963 Enrollment ID: I20250530002477 |
| Provider Name | Laurie Kay Lahti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083344295 PECOS PAC ID: 5991215592 Enrollment ID: I20250612000557 |
Coffee Hour Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 26185 Wick Rd, Taylor, MI 48180 Phone: 313-615-0005 | |
Michigan Neuroscience Clinic Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 11780 Telegraph Rd Ste 100, Taylor, MI 48180 Phone: 734-374-1112 Fax: 734-374-1119 | |
Faithfully Her Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9410 E Pickwick Cir, Taylor, MI 48180 Phone: 313-204-5507 | |
Center For Individual & Family Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21751 Ecorse Rd, Taylor, MI 48180 Phone: 313-291-7000 Fax: 313-291-0942 | |
Modern Psych And Wellness Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 21415 Goddard Rd, Taylor, MI 48180 Phone: 313-737-0023 | |
Downriver Mental Health Clinic Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20500 Eureka Rd, Suite 200, Taylor, MI 48180 Phone: 734-285-8282 Fax: 734-281-0402 | |
Park Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20600 Eureka Rd Ste 819, Taylor, MI 48180 Phone: 734-285-8282 |