| Healthport | |
|
505 E Main St Salisbury MD 21804 | |
| (410) 341-3420 | |
| (410) 341-3397 |
| Full Name | Healthport |
|---|---|
| Speciality | Clinic/Center |
| Location | 505 E Main St, Salisbury, Maryland |
| Authorized Official Name and Position | Kristine Gartlitz (VICE PRESIDENT) |
| Authorized Official Contact | 4102022651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthport 208 E Main St Ste C Salisbury MD 21801-4923 Ph: (410) 341-3420 | Healthport 505 E Main St Salisbury MD 21804 Ph: (410) 341-3420 |
| NPI Number | 1154320646 |
|---|---|
| Provider Enumeration Date | 07/18/2005 |
| Last Update Date | 03/04/2025 |
| Certification Date | 03/04/2025 |
| Medicare PECOS PAC ID | 2365469947 |
|---|---|
| Medicare Enrollment ID | O20051102000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154320646 | NPI | - | NPPES |
| 298470900 | Medicaid | MD | |
| LS92 | Other | MD | BLUE CROSS BLUE SHIELD MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Maryland) | Primary |
| Provider Name | Efigenio Bautista |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427032705 PECOS PAC ID: 2860388014 Enrollment ID: I20040224001265 |
| Provider Name | Shashikala Venkatachalapathy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669555462 PECOS PAC ID: 3577665207 Enrollment ID: I20070226000736 |
| Provider Name | Helen F Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255495511 PECOS PAC ID: 0749453165 Enrollment ID: I20111101000059 |
| Provider Name | Kristine Garlitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356608137 PECOS PAC ID: 9335301654 Enrollment ID: I20120503000210 |
| Provider Name | Jeannette Kathleen Buchanan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164773248 PECOS PAC ID: 2062667231 Enrollment ID: I20160408000692 |
| Provider Name | Kristine Hickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629515812 PECOS PAC ID: 3870879588 Enrollment ID: I20170412001627 |
| Provider Name | Kelly M Beeseck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750840203 PECOS PAC ID: 6406181023 Enrollment ID: I20190718000457 |
| Provider Name | Rachel Z Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255728648 PECOS PAC ID: 8325379480 Enrollment ID: I20191004000214 |
| Provider Name | Michele Y Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578104899 PECOS PAC ID: 2264866573 Enrollment ID: I20191219001164 |
| Provider Name | Staci Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215545116 PECOS PAC ID: 9537585740 Enrollment ID: I20200819000953 |
| Provider Name | Chelsea Renee Pantalone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649915489 PECOS PAC ID: 3779960307 Enrollment ID: I20220519001439 |
| Provider Name | Tamara M Dougherty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164790663 PECOS PAC ID: 5991154916 Enrollment ID: I20231215000029 |
| Provider Name | Teresa Beath |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255908711 PECOS PAC ID: 3173973484 Enrollment ID: I20231229000027 |
| Provider Name | Christianna Bull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477306603 PECOS PAC ID: 6103265608 Enrollment ID: I20240417000580 |
| Provider Name | Emily Ruffo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851990873 PECOS PAC ID: 5496294118 Enrollment ID: I20240827000089 |
| Provider Name | Beverly Marie Twigg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609690981 PECOS PAC ID: 8325575517 Enrollment ID: I20241230002491 |
| Provider Name | Lauren Michelle Engleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972309870 PECOS PAC ID: 2961923271 Enrollment ID: I20250303003099 |
New Transitions, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1118 E Main St, Salisbury, MD 21804 Phone: 410-219-5070 | |
Compass Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2326 Goddard Pkwy Unit A, Salisbury, MD 21801 Phone: 443-978-7803 Fax: 443-978-7827 | |
Cove Recovery, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 540 Riverside Drive, Suite 8, Salisbury, MD 21801 Phone: 410-548-3333 Fax: 410-548-3341 | |
Riverside Neurology Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 Riverside Dr Ste B204, Salisbury, MD 21801 Phone: 410-546-5722 Fax: 410-546-5851 | |
Dr. Leslie Donnelly And Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 W Main St, Suite 201, Salisbury, MD 21801 Phone: 410-742-7160 Fax: 410-546-1048 | |
The Personal Wellness Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6508 Deer Pointe Dr Ste 4c, Salisbury, MD 21804 Phone: 410-742-6016 Fax: 410-742-6014 | |
Push Health And Wellness, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1321 Mount Hermon Rd # C-1, Salisbury, MD 21804 Phone: 443-736-8661 |