| Mind Redo | |
|
7320 State Route 108 Ste A Wauseon OH 43567-9244 | |
| (419) 285-6655 | |
| Not Available |
| Full Name | Mind Redo |
|---|---|
| Speciality | Clinic/Center |
| Location | 7320 State Route 108 Ste A, Wauseon, Ohio |
| Authorized Official Name and Position | Sondra L Metts (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4192856655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Redo 7320 State Route 108 Ste A Wauseon OH 43567-9244 Ph: (419) 285-6655 | Mind Redo 7320 State Route 108 Ste A Wauseon OH 43567-9244 Ph: (419) 285-6655 |
| NPI Number | 1497386148 |
|---|---|
| Provider Enumeration Date | 01/31/2020 |
| Last Update Date | 01/31/2020 |
| Certification Date | 01/31/2020 |
| Medicare PECOS PAC ID | 8123432937 |
|---|---|
| Medicare Enrollment ID | O20210205000656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497386148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Marissa M Baus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376979286 PECOS PAC ID: 6608005459 Enrollment ID: I20140128000450 |
| Provider Name | Kelly Genene Routhier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336506013 PECOS PAC ID: 0345529848 Enrollment ID: I20161123001411 |
| Provider Name | Jennifer J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497233613 PECOS PAC ID: 2365787181 Enrollment ID: I20181226002228 |
| Provider Name | Chelsea Kahle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962004374 PECOS PAC ID: 7113330721 Enrollment ID: I20201228001727 |
| Provider Name | Lisa Lynn Greer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528722857 PECOS PAC ID: 8628467776 Enrollment ID: I20211111002366 |
| Provider Name | Pammella Ngefor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982911962 PECOS PAC ID: 5294127106 Enrollment ID: I20220126000464 |
| Provider Name | Angela Marie Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093479370 PECOS PAC ID: 4789070731 Enrollment ID: I20220331001021 |
Aja Behavioral Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1115-1 N Shoop Ave, Wauseon, OH 43567 Phone: 419-335-6122 Fax: 419-318-4157 | |
Family Services Of Northwest Ohio Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7320 State Highway 108 Ste A, Wauseon, OH 43567 Phone: 419-335-3732 Fax: 419-335-3462 | |
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Joy D Fruchey And Associates, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 850 W Elm St, Wauseon, OH 43567 Phone: 567-343-6068 | |
Family Service Of Northwest Ohio Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7320 State Highway 108, Suite A, Wauseon, OH 43567 Phone: 419-335-3732 Fax: 419-335-3462 |