| Milestones Clinical & Health Resources | |
|
550 S Adams St Bloomington IN 47403-2165 | |
| (812) 333-6324 | |
| Not Available |
| Full Name | Milestones Clinical & Health Resources |
|---|---|
| Speciality | Clinic/Center |
| Location | 550 S Adams St, Bloomington, Indiana |
| Authorized Official Name and Position | Elizabeth Dewees (CEO) |
| Authorized Official Contact | 8123322168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milestones Clinical & Health Resources 2815 E 10th St Bloomington IN 47408-2601 Ph: () - | Milestones Clinical & Health Resources 550 S Adams St Bloomington IN 47403-2165 Ph: (812) 333-6324 |
| NPI Number | 1730240888 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Medicare PECOS PAC ID | 8820900111 |
|---|---|
| Medicare Enrollment ID | O20031104000666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730240888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Bethany A Murray |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1023094174 PECOS PAC ID: 1052480381 Enrollment ID: I20080513000389 |
| Provider Name | Angela Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457708885 PECOS PAC ID: 3072803790 Enrollment ID: I20160608000272 |
| Provider Name | Leah D Walden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275001554 PECOS PAC ID: 7911248778 Enrollment ID: I20190405000057 |
| Provider Name | Grant Thomas Gilliam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730659301 PECOS PAC ID: 0749638872 Enrollment ID: I20231129002338 |
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