| Neustart Psychiatry | |
|
2110 Mission St Se Ste 305 Salem OR 97302-0038 | |
| (503) 379-1902 | |
| Not Available |
| Full Name | Neustart Psychiatry |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2110 Mission St Se Ste 305, Salem, Oregon |
| Authorized Official Name and Position | Lawrence K Robbins (OWNER) |
| Authorized Official Contact | 3609986593 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neustart Psychiatry 2110 Mission St Se Ste 305 Salem OR 97302-0038 Ph: (503) 379-1902 | Neustart Psychiatry 2110 Mission St Se Ste 305 Salem OR 97302-0038 Ph: (503) 379-1902 |
| NPI Number | 1780166116 |
|---|---|
| Provider Enumeration Date | 09/01/2018 |
| Last Update Date | 09/13/2022 |
| Certification Date | 09/13/2022 |
| Medicare PECOS PAC ID | 2062751357 |
|---|---|
| Medicare Enrollment ID | O20190304002804 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780166116 | NPI | - | NPPES |
| 500754977 | Medicaid | OR |
| Provider Name | Erum A Khaleeq |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1902915770 PECOS PAC ID: 3577559798 Enrollment ID: I20040422001488 |
| Provider Name | Sabine G Hyatt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932413150 PECOS PAC ID: 2163618950 Enrollment ID: I20110726000704 |
| Provider Name | Tara L Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598807158 PECOS PAC ID: 2466623624 Enrollment ID: I20110920000022 |
| Provider Name | Sarah Frances Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235493495 PECOS PAC ID: 4880502665 Enrollment ID: I20190516002295 |
| Provider Name | Taylor Ballew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093272759 PECOS PAC ID: 0749619252 Enrollment ID: I20200404000515 |
| Provider Name | Heather Shipley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114363371 PECOS PAC ID: 6103255617 Enrollment ID: I20200404000531 |
| Provider Name | Svetlana Orlova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124503941 PECOS PAC ID: 9133550783 Enrollment ID: I20200514001230 |
| Provider Name | Kassandra Ransom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124682232 PECOS PAC ID: 7911325782 Enrollment ID: I20200910000911 |
| Provider Name | Heather Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790398238 PECOS PAC ID: 3870913536 Enrollment ID: I20201019001025 |
| Provider Name | Tallon Reeder Lamoreaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487028361 PECOS PAC ID: 3779903455 Enrollment ID: I20201019001988 |
| Provider Name | Ramon Nava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245845692 PECOS PAC ID: 2163836404 Enrollment ID: I20210128001396 |
| Provider Name | Schuyler Blake Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538709738 PECOS PAC ID: 6608284260 Enrollment ID: I20210420001116 |
| Provider Name | Jonathan Mccully |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396334264 PECOS PAC ID: 9335557719 Enrollment ID: I20210423001703 |
| Provider Name | Bethany Kristine Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124620117 PECOS PAC ID: 2365841160 Enrollment ID: I20210527002183 |
| Provider Name | Helen V Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578114856 PECOS PAC ID: 2567867765 Enrollment ID: I20210826001644 |
| Provider Name | Dana Marie Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932872363 PECOS PAC ID: 3779989553 Enrollment ID: I20210901004030 |
| Provider Name | Hope Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578945473 PECOS PAC ID: 2466858774 Enrollment ID: I20210913002137 |
| Provider Name | Amanda Nicole Ray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669822573 PECOS PAC ID: 2769880400 Enrollment ID: I20211009000166 |
| Provider Name | Sara Christman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740816131 PECOS PAC ID: 4789001991 Enrollment ID: I20211102000343 |
| Provider Name | Lynaudry Vickers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992358493 PECOS PAC ID: 5092107763 Enrollment ID: I20220110002475 |
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