| New Oakland Child-adolescent And Family Center | |
|
6549 Town Center Dr Suite A Clarkston MI 48346-4824 | |
| (248) 620-6400 | |
| (248) 620-6405 |
| Full Name | New Oakland Child-adolescent And Family Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 6549 Town Center Dr, Clarkston, Michigan |
| Authorized Official Name and Position | Julia Schiappacasse (ASST. DIRECTOR) |
| Authorized Official Contact | 2488551540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Oakland Child-adolescent And Family Center 6549 Town Center Dr Suite A Clarkston MI 48346-4824 Ph: (248) 620-6400 | New Oakland Child-adolescent And Family Center 6549 Town Center Dr Suite A Clarkston MI 48346-4824 Ph: (248) 620-6400 |
| NPI Number | 1609882067 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 09/12/2016 |
| Medicare PECOS PAC ID | 4688674534 |
|---|---|
| Medicare Enrollment ID | O20061228000140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609882067 | NPI | - | NPPES |
| 1609882067 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jeffrey A Sendi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730167800 PECOS PAC ID: 9436058328 Enrollment ID: I20040108000893 |
| Provider Name | Robert M Hermanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053457192 PECOS PAC ID: 3577466994 Enrollment ID: I20040131000214 |
| Provider Name | Alejandro Zapata |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467461855 PECOS PAC ID: 8426945825 Enrollment ID: I20040301001095 |
| Provider Name | Orlena B Merritt Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982632824 PECOS PAC ID: 4284535766 Enrollment ID: I20040309001292 |
| Provider Name | Malinda L Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235380791 PECOS PAC ID: 2860462074 Enrollment ID: I20040727000520 |
| Provider Name | Norma K Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528003571 PECOS PAC ID: 4385614205 Enrollment ID: I20040728001192 |
| Provider Name | Jeannette Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487766606 PECOS PAC ID: 5193799732 Enrollment ID: I20040820000490 |
| Provider Name | Carol A Roekle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902944507 PECOS PAC ID: 8123095213 Enrollment ID: I20040916001137 |
| Provider Name | David K Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497799951 PECOS PAC ID: 9537137195 Enrollment ID: I20040921000951 |
| Provider Name | Michael H Watts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447260419 PECOS PAC ID: 3577476118 Enrollment ID: I20041104000621 |
| Provider Name | Bridgette M Cavette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750578209 PECOS PAC ID: 0941265003 Enrollment ID: I20041130000922 |
| Provider Name | Avelyn E Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396861928 PECOS PAC ID: 9133185606 Enrollment ID: I20041208000185 |
| Provider Name | Kelly Klings-elander |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295853604 PECOS PAC ID: 8628026689 Enrollment ID: I20050106000067 |
| Provider Name | Mark L Diroff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578571642 PECOS PAC ID: 0042269334 Enrollment ID: I20050113000374 |
| Provider Name | Jaime Ayala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235180720 PECOS PAC ID: 7810967601 Enrollment ID: I20050301000336 |
| Provider Name | Janice Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982630950 PECOS PAC ID: 5890738165 Enrollment ID: I20050607001212 |
| Provider Name | Mary H Hoekstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932276037 PECOS PAC ID: 2769418474 Enrollment ID: I20050714000130 |
| Provider Name | Mary Schoettle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356479869 PECOS PAC ID: 2062443252 Enrollment ID: I20050827000030 |
| Provider Name | Ellen M Rotblatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437119872 PECOS PAC ID: 9537185079 Enrollment ID: I20051024000436 |
| Provider Name | Marcie Israel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780623736 PECOS PAC ID: 5496760134 Enrollment ID: I20060216000139 |
| Provider Name | Fedor Opochinsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720030968 PECOS PAC ID: 8729093273 Enrollment ID: I20060221000033 |
| Provider Name | Susan E Ruma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720155096 PECOS PAC ID: 0648286468 Enrollment ID: I20060302000271 |
| Provider Name | Aurora Andrews |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861590259 PECOS PAC ID: 7517963952 Enrollment ID: I20061009000196 |
| Provider Name | Michelle L Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235235813 PECOS PAC ID: 8426056011 Enrollment ID: I20061114000540 |
| Provider Name | Robin Tiffany Sharabani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245248319 PECOS PAC ID: 6901806793 Enrollment ID: I20061229000057 |
| Provider Name | Charisse Hoppe Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255349320 PECOS PAC ID: 7911907795 Enrollment ID: I20070103000487 |
| Provider Name | Robert A Bringman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881602951 PECOS PAC ID: 7416958905 Enrollment ID: I20070126000019 |
| Provider Name | Susha Panicker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558410787 PECOS PAC ID: 3274535042 Enrollment ID: I20070207000249 |
| Provider Name | Kimberly B Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114930690 PECOS PAC ID: 0749386621 Enrollment ID: I20070509000747 |
| Provider Name | Henry Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033243332 PECOS PAC ID: 2769589415 Enrollment ID: I20070515000296 |
| Provider Name | Marina Vicini Pokriefka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225046394 PECOS PAC ID: 5890881858 Enrollment ID: I20071024000593 |
| Provider Name | Hanif Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609030147 PECOS PAC ID: 2466529474 Enrollment ID: I20080917000205 |
| Provider Name | Robert J Lagrou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629279351 PECOS PAC ID: 3779645270 Enrollment ID: I20081217000396 |
| Provider Name | Chlorine F Wimberly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598910986 PECOS PAC ID: 0840356465 Enrollment ID: I20090306000182 |
| Provider Name | Dennis W Schinzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093040966 PECOS PAC ID: 6709926306 Enrollment ID: I20091215000311 |
| Provider Name | Marilyn S Hamer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528264041 PECOS PAC ID: 4385774124 Enrollment ID: I20100604000891 |
| Provider Name | Charlotte Beachem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316126824 PECOS PAC ID: 9032308556 Enrollment ID: I20110113000706 |
| Provider Name | Joyweena M Glaser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407157043 PECOS PAC ID: 5890970826 Enrollment ID: I20110506000080 |
| Provider Name | Mikayla L Tanner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487859005 PECOS PAC ID: 5395921936 Enrollment ID: I20110517000420 |
| Provider Name | Maria Nicole A Villafuerte |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659576718 PECOS PAC ID: 4082892393 Enrollment ID: I20110708000262 |
| Provider Name | Lisa A Neverdamsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245354984 PECOS PAC ID: 0648443358 Enrollment ID: I20111025000352 |
| Provider Name | Melissa L Kozlowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831228741 PECOS PAC ID: 0941460463 Enrollment ID: I20120321000048 |
| Provider Name | Shama D Patil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194844407 PECOS PAC ID: 0446414080 Enrollment ID: I20120612000537 |
| Provider Name | Sharon K Music |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942576541 PECOS PAC ID: 3173788635 Enrollment ID: I20120723000396 |
| Provider Name | Karen Skrzypek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548527419 PECOS PAC ID: 5698924504 Enrollment ID: I20121010000236 |
| Provider Name | Kara E Bunton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982918454 PECOS PAC ID: 5698925337 Enrollment ID: I20121016000025 |
| Provider Name | Laura A Bloom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326392531 PECOS PAC ID: 2062664386 Enrollment ID: I20121213000434 |
| Provider Name | Doresea Lewis-bogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124218466 PECOS PAC ID: 7315182979 Enrollment ID: I20130402000289 |
| Provider Name | Sandra G Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437183803 PECOS PAC ID: 1850537820 Enrollment ID: I20130417000376 |
| Provider Name | William S Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659581270 PECOS PAC ID: 0446498893 Enrollment ID: I20130524000599 |
| Provider Name | Melinda S Triemstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356448054 PECOS PAC ID: 8325286677 Enrollment ID: I20130529000293 |
| Provider Name | Monica Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346258795 PECOS PAC ID: 3678670866 Enrollment ID: I20130911000832 |
| Provider Name | Dalal Berry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760826176 PECOS PAC ID: 7012145709 Enrollment ID: I20131231000908 |
| Provider Name | Sushma Gunturu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861723215 PECOS PAC ID: 9537398524 Enrollment ID: I20140218000359 |
| Provider Name | Jason A Maroudis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174954531 PECOS PAC ID: 9537399258 Enrollment ID: I20140225001678 |
| Provider Name | Jessica Y Youhanna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336483361 PECOS PAC ID: 0547492670 Enrollment ID: I20140403001951 |
| Provider Name | Emily M Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487916334 PECOS PAC ID: 2365666773 Enrollment ID: I20140604001856 |
| Provider Name | Cynthia A Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417361361 PECOS PAC ID: 9739305210 Enrollment ID: I20140717002360 |
| Provider Name | Mary E Tinklepaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245654441 PECOS PAC ID: 0345466645 Enrollment ID: I20140722002728 |
| Provider Name | Marie H Putnam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215187000 PECOS PAC ID: 5193943595 Enrollment ID: I20140827000420 |
| Provider Name | Kathy Chen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811339534 PECOS PAC ID: 2365764305 Enrollment ID: I20141203000346 |
| Provider Name | Michael J Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851794788 PECOS PAC ID: 7618294547 Enrollment ID: I20150402000457 |
| Provider Name | Laurie Rogoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396908117 PECOS PAC ID: 8022336817 Enrollment ID: I20150407000931 |
| Provider Name | Mallory Mcdonough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144569559 PECOS PAC ID: 9830417245 Enrollment ID: I20150415001691 |
| Provider Name | Tina M Sims |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952676181 PECOS PAC ID: 2264751650 Enrollment ID: I20150506002497 |
| Provider Name | Meghan Alderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386067874 PECOS PAC ID: 6305166497 Enrollment ID: I20150513000089 |
| Provider Name | Adenike K Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962782227 PECOS PAC ID: 6901117563 Enrollment ID: I20150623002190 |
| Provider Name | Michelle D Modlinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578951729 PECOS PAC ID: 5193038651 Enrollment ID: I20150714000222 |
| Provider Name | Angela Cameruci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194139477 PECOS PAC ID: 9032423272 Enrollment ID: I20150803000253 |
| Provider Name | Gail I Kiacz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538485115 PECOS PAC ID: 9638484207 Enrollment ID: I20150812007533 |
| Provider Name | Nicholas D Weiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548514904 PECOS PAC ID: 0547579203 Enrollment ID: I20151020000368 |
| Provider Name | Lauren Fournier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891128427 PECOS PAC ID: 5799085411 Enrollment ID: I20151202002583 |
| 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 | Libby Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720452931 PECOS PAC ID: 2860796711 Enrollment ID: I20160212001573 |
| Provider Name | Jennifer J Gee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962832675 PECOS PAC ID: 8123325065 Enrollment ID: I20160323002680 |
| Provider Name | Mohammad Hanif |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114976503 PECOS PAC ID: 6002842804 Enrollment ID: I20160511000091 |
| Provider Name | Kimberly Poirier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588065098 PECOS PAC ID: 4183917453 Enrollment ID: I20160725000488 |
| Provider Name | Trina Mason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992258362 PECOS PAC ID: 9234423377 Enrollment ID: I20160811001833 |
| Provider Name | Lindsey Cisse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043623283 PECOS PAC ID: 4486948569 Enrollment ID: I20160812000113 |
| Provider Name | Kaitlin Short |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376924076 PECOS PAC ID: 1850686650 Enrollment ID: I20160818000119 |
| Provider Name | James T King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982795845 PECOS PAC ID: 2860788379 Enrollment ID: I20160909001039 |
| Provider Name | Scott Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912235391 PECOS PAC ID: 0648567164 Enrollment ID: I20160928000372 |
| Provider Name | Kimberly R Mahaffa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508284951 PECOS PAC ID: 3173802451 Enrollment ID: I20161108002441 |
| Provider Name | April Marie Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568803740 PECOS PAC ID: 0446531644 Enrollment ID: I20161230000890 |
| Provider Name | Gwendolyn La Croix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801343942 PECOS PAC ID: 9537443742 Enrollment ID: I20170308001087 |
| Provider Name | Katherine Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508234162 PECOS PAC ID: 9234415936 Enrollment ID: I20170412001209 |
| Provider Name | Frank Almaflahi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427471002 PECOS PAC ID: 4880961366 Enrollment ID: I20170605002349 |
| Provider Name | Jennifer Renae Kljajic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346645413 PECOS PAC ID: 1456629484 Enrollment ID: I20170616000471 |
| Provider Name | Sarah Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942724463 PECOS PAC ID: 0648544627 Enrollment ID: I20170915000081 |
| Provider Name | Mary L Helminen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821515644 PECOS PAC ID: 6103190921 Enrollment ID: I20170918002424 |
| 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 | Jennifer Ann Oles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407126030 PECOS PAC ID: 4385900356 Enrollment ID: I20171107002294 |
| Provider Name | Steven Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902287527 PECOS PAC ID: 1759641384 Enrollment ID: I20180130002358 |
| Provider Name | Amber L.m. Hickman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154729275 PECOS PAC ID: 8527329143 Enrollment ID: I20180222001980 |
| Provider Name | Karen Teves-frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528255247 PECOS PAC ID: 5092078618 Enrollment ID: I20180413000166 |
| Provider Name | Anthonia Umelogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518485911 PECOS PAC ID: 1759644933 Enrollment ID: I20180423000990 |
| Provider Name | Diana Vitale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265969349 PECOS PAC ID: 9638432818 Enrollment ID: I20180423001099 |
| Provider Name | Jennifer Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376939926 PECOS PAC ID: 6103181771 Enrollment ID: I20180531002201 |
| Provider Name | Tiffany R Chenault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710394044 PECOS PAC ID: 8325393721 Enrollment ID: I20180625003686 |
| Provider Name | Natashia Hurley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396156535 PECOS PAC ID: 5092069963 Enrollment ID: I20181112001651 |
| Provider Name | Jessica Klemanski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033613435 PECOS PAC ID: 3779837364 Enrollment ID: I20181119000126 |
| Provider Name | Chastidy Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114268208 PECOS PAC ID: 7012251366 Enrollment ID: I20181128000319 |
| Provider Name | Vanessa Lynn Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326530056 PECOS PAC ID: 6608111760 Enrollment ID: I20181218000457 |
| Provider Name | Cody Shinavier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952878092 PECOS PAC ID: 0941545412 Enrollment ID: I20190103000476 |
| Provider Name | Shiba L Nixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679041545 PECOS PAC ID: 6002151578 Enrollment ID: I20190103000573 |
| Provider Name | Kimberly Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386088763 PECOS PAC ID: 6406191998 Enrollment ID: I20190103001170 |
| Provider Name | Catherine Barry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205294097 PECOS PAC ID: 3971841339 Enrollment ID: I20190208002103 |
| Provider Name | Nazish Siddiqui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740745173 PECOS PAC ID: 7517206766 Enrollment ID: I20190305002536 |
| Provider Name | Annett Uduji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922526029 PECOS PAC ID: 1759622897 Enrollment ID: I20190417002892 |
| Provider Name | Francine L Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821546375 PECOS PAC ID: 0840532974 Enrollment ID: I20190422000159 |
| Provider Name | Rebecca M Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386072528 PECOS PAC ID: 9234466988 Enrollment ID: I20190805000438 |
| Provider Name | Sara Ziel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225570690 PECOS PAC ID: 1850620337 Enrollment ID: I20190909002303 |
| Provider Name | Chelsea Antilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861048829 PECOS PAC ID: 0345579678 Enrollment ID: I20190911000986 |
| Provider Name | Janessa G Perrin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255702080 PECOS PAC ID: 1557798311 Enrollment ID: I20200218000516 |
| Provider Name | Kathleen Frybarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306476809 PECOS PAC ID: 9335576206 Enrollment ID: I20200305002568 |
| Provider Name | Mayche Vang-kue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659919819 PECOS PAC ID: 2062849938 Enrollment ID: I20200305002584 |
| Provider Name | Amanda Mcfarland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174078000 PECOS PAC ID: 5597193136 Enrollment ID: I20200315000031 |
| Provider Name | Madison E Henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841724010 PECOS PAC ID: 1456772987 Enrollment ID: I20200609000335 |
| 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 | Anna Baur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619492071 PECOS PAC ID: 4385058460 Enrollment ID: I20210201002131 |
| Provider Name | Lonneisha Rutherford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700237526 PECOS PAC ID: 2264846344 Enrollment ID: I20210201002273 |
| Provider Name | Jasmine L Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669832663 PECOS PAC ID: 9931516788 Enrollment ID: I20210324000520 |
| Provider Name | Bradley Winter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063013290 PECOS PAC ID: 2163830985 Enrollment ID: I20210415002941 |
| Provider Name | Irene Voss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750981577 PECOS PAC ID: 5799193512 Enrollment ID: I20210415002972 |
| Provider Name | Tyrell Boydston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417306861 PECOS PAC ID: 7012325848 Enrollment ID: I20210416000112 |
| Provider Name | Sha'miya Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518487966 PECOS PAC ID: 9931517158 Enrollment ID: I20210427003037 |
| Provider Name | Kelley Gavigan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518483189 PECOS PAC ID: 6608276662 Enrollment ID: I20210611002126 |
| Provider Name | Hannah Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699359364 PECOS PAC ID: 6709289846 Enrollment ID: I20210727000951 |
| Provider Name | Hillary Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629638895 PECOS PAC ID: 8729481700 Enrollment ID: I20210728002604 |
| Provider Name | Ashley Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073098919 PECOS PAC ID: 9537562350 Enrollment ID: I20210730000551 |
| Provider Name | Neil Sacks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255805685 PECOS PAC ID: 3173926995 Enrollment ID: I20210730000557 |
| Provider Name | Emily Alberta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598347601 PECOS PAC ID: 8426448721 Enrollment ID: I20211130002510 |
| Provider Name | Paramjeet Chadha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710498654 PECOS PAC ID: 1759771066 Enrollment ID: I20211130002704 |
| Provider Name | William Beamish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912457516 PECOS PAC ID: 2264822055 Enrollment ID: I20211210000203 |
| Provider Name | Kevin P Bautel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598428856 PECOS PAC ID: 1759771389 Enrollment ID: I20211214000865 |
| Provider Name | Mohammed Joz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407528672 PECOS PAC ID: 4981605144 Enrollment ID: I20211222002136 |
| Provider Name | Carall Fillinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699317461 PECOS PAC ID: 3072904853 Enrollment ID: I20220105002241 |
| Provider Name | Jenna Galati |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306502117 PECOS PAC ID: 6103218417 Enrollment ID: I20220119000492 |
| Provider Name | Curtis Leipold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801552336 PECOS PAC ID: 4385038637 Enrollment ID: I20220302001243 |
| Provider Name | Shannon Mcclelland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336716000 PECOS PAC ID: 5294129268 Enrollment ID: I20220308002899 |
| Provider Name | Carolada Delores Gilbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831528140 PECOS PAC ID: 5294120002 Enrollment ID: I20220314001814 |
| Provider Name | Melissa Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922538941 PECOS PAC ID: 1052790458 Enrollment ID: I20220615000684 |
| Provider Name | Amita Kapoor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508502436 PECOS PAC ID: 8325420318 Enrollment ID: I20220808002591 |
| Provider Name | Jasmine Al-sheikh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740894849 PECOS PAC ID: 5991188351 Enrollment ID: I20220817001960 |
| Provider Name | Casey Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588130389 PECOS PAC ID: 0446636476 Enrollment ID: I20220928003522 |
| Provider Name | Ashley Vanputten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821622960 PECOS PAC ID: 2466828652 Enrollment ID: I20221012003294 |
| Provider Name | Maria Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912541053 PECOS PAC ID: 5991173106 Enrollment ID: I20221118002726 |
| Provider Name | Zeeshan Choudhry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770210924 PECOS PAC ID: 0042688640 Enrollment ID: I20221201000498 |
| Provider Name | Nadia Berenjian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720672108 PECOS PAC ID: 5597134486 Enrollment ID: I20221215002814 |
| Provider Name | Anika Davis-watley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932587995 PECOS PAC ID: 8022487917 Enrollment ID: I20221215002862 |
| Provider Name | Annissa Rosser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285290536 PECOS PAC ID: 9830560457 Enrollment ID: I20230118002504 |
| Provider Name | James Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295257525 PECOS PAC ID: 5294106811 Enrollment ID: I20230118002516 |
| Provider Name | Dennis Lin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760191464 PECOS PAC ID: 7911378179 Enrollment ID: I20230125003355 |
| Provider Name | Nilo Elizalde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841854635 PECOS PAC ID: 0648641845 Enrollment ID: I20230126001735 |
| Provider Name | Candes Anderson-gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114559754 PECOS PAC ID: 2365814266 Enrollment ID: I20230201003087 |
| Provider Name | Teri Falcon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124662622 PECOS PAC ID: 1153796719 Enrollment ID: I20230412002456 |
| Provider Name | David Copeland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003399478 PECOS PAC ID: 3779958293 Enrollment ID: I20230413002107 |
| Provider Name | Desiree Messina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366033433 PECOS PAC ID: 2163887605 Enrollment ID: I20230505000144 |
| Provider Name | Matthew Bautel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245951870 PECOS PAC ID: 6204291701 Enrollment ID: I20230506000268 |
| 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 | Raphael Tramble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447864129 PECOS PAC ID: 2860850690 Enrollment ID: I20230626003035 |
| Provider Name | Ariana Ballard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558929976 PECOS PAC ID: 8022476852 Enrollment ID: I20230626003087 |
| Provider Name | Sieglinde Stearns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518478932 PECOS PAC ID: 9739540501 Enrollment ID: I20230727000787 |
| Provider Name | Krystal Barrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588116107 PECOS PAC ID: 8224499587 Enrollment ID: I20230802003107 |
| Provider Name | Jessica Aiello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861084337 PECOS PAC ID: 6608220975 Enrollment ID: I20230921000243 |
| Provider Name | Celeste Fortune |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992371140 PECOS PAC ID: 2961856232 Enrollment ID: I20230921000268 |
| Provider Name | Emily Torossian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104416221 PECOS PAC ID: 6507210887 Enrollment ID: I20230921000682 |
| Provider Name | Fadra Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841876620 PECOS PAC ID: 0446604342 Enrollment ID: I20230926003968 |
| Provider Name | Kanika Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982006722 PECOS PAC ID: 4183078009 Enrollment ID: I20230927000418 |
| Provider Name | Melinda Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104336569 PECOS PAC ID: 2961856687 Enrollment ID: I20230929000801 |
| Provider Name | Amy Salley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992456701 PECOS PAC ID: 4183072283 Enrollment ID: I20231130001011 |
| Provider Name | Lakita Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972224046 PECOS PAC ID: 8224486014 Enrollment ID: I20231205001711 |
| Provider Name | Amy Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104402379 PECOS PAC ID: 0042668832 Enrollment ID: I20231205001721 |
| Provider Name | Masuma Jinnat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164040382 PECOS PAC ID: 9335598515 Enrollment ID: I20231213002082 |
| Provider Name | Howard Chang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811632433 PECOS PAC ID: 9234589110 Enrollment ID: I20231219003007 |
| Provider Name | Joseph Jaster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588850705 PECOS PAC ID: 4385094788 Enrollment ID: I20231227002910 |
| Provider Name | Martha Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558776104 PECOS PAC ID: 8123479425 Enrollment ID: I20240111001466 |
| Provider Name | Christina Petzel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104042548 PECOS PAC ID: 8628429883 Enrollment ID: I20240111004143 |
| Provider Name | Metaxas Simon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265034557 PECOS PAC ID: 1951752112 Enrollment ID: I20240111004282 |
| Provider Name | Sandra Siegel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427431485 PECOS PAC ID: 5193176360 Enrollment ID: I20240111004500 |
| Provider Name | Katherine Deppong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073942785 PECOS PAC ID: 8729439997 Enrollment ID: I20240111004504 |
| Provider Name | Joel Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831768415 PECOS PAC ID: 1052762234 Enrollment ID: I20240111004706 |
| Provider Name | Megan Ellery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871953000 PECOS PAC ID: 2466804984 Enrollment ID: I20240122000186 |
| Provider Name | Kathryn Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336612746 PECOS PAC ID: 0345692794 Enrollment ID: I20240122001443 |
| Provider Name | Christina Polk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568759777 PECOS PAC ID: 3678925054 Enrollment ID: I20240122002355 |
| Provider Name | Kevin Bradacs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700248382 PECOS PAC ID: 2365894748 Enrollment ID: I20240122002505 |
| Provider Name | Christine Okeefe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508420845 PECOS PAC ID: 1052763372 Enrollment ID: I20240122004247 |
| Provider Name | Tiffany Roy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497097703 PECOS PAC ID: 1850744483 Enrollment ID: I20240130002196 |
| Provider Name | Bronwyn Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457872822 PECOS PAC ID: 0941653596 Enrollment ID: I20240130003058 |
| Provider Name | Kaitlyn Siporin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184221293 PECOS PAC ID: 9436502051 Enrollment ID: I20240131001245 |
| Provider Name | Jennifer Prestenbach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104198332 PECOS PAC ID: 7214380831 Enrollment ID: I20240131001382 |
| Provider Name | Thomas Sudia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790874410 PECOS PAC ID: 6305299827 Enrollment ID: I20240131001790 |
| Provider Name | Lisa Heximer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396049870 PECOS PAC ID: 0547613069 Enrollment ID: I20240131001931 |
| Provider Name | Brandon Ugolini |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528485604 PECOS PAC ID: 1456704998 Enrollment ID: I20240131002335 |
| Provider Name | Lynn Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881042984 PECOS PAC ID: 2769835206 Enrollment ID: I20240131002572 |
| Provider Name | Sarah Couturier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932618840 PECOS PAC ID: 8921451477 Enrollment ID: I20240131002680 |
| Provider Name | Nicholas Lewan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770183956 PECOS PAC ID: 6901259456 Enrollment ID: I20240131002776 |
| Provider Name | Jillian Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033447545 PECOS PAC ID: 1850432451 Enrollment ID: I20240131003561 |
| Provider Name | Omega Mostyn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467021741 PECOS PAC ID: 5294188777 Enrollment ID: I20240131003908 |
| Provider Name | Kenneth York |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215236328 PECOS PAC ID: 8921451428 Enrollment ID: I20240131004542 |
| Provider Name | James Collada |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356612766 PECOS PAC ID: 2567813686 Enrollment ID: I20240201000689 |
| Provider Name | Alexis Ayar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073184214 PECOS PAC ID: 9133562036 Enrollment ID: I20240207003942 |
| Provider Name | Elizabeth Mcgee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003151523 PECOS PAC ID: 1557704483 Enrollment ID: I20240208000447 |
| Provider Name | Kristina Breidenstein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245885730 PECOS PAC ID: 5991149189 Enrollment ID: I20240215001787 |
| Provider Name | Lisa Kalinski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336157403 PECOS PAC ID: 5092150557 Enrollment ID: I20240224000066 |
Clarity Counseling Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6300 Sashabaw Rd Ste B, Clarkston, MI 48346 Phone: 517-202-2427 | |
12th Avenue Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5541 Warbler Dr, Clarkston, MI 48346 Phone: 248-795-5253 Fax: 248-928-5350 | |
Life Solutions Coaching Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8040 Ortonville Rd, Clarkston, MI 48348 Phone: 248-707-9477 | |
Milestones Aba Clinic Of Michigan Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5125 Indianwood Dr, Clarkston, MI 48348 Phone: 248-983-4828 Fax: 248-983-4839 | |
Kindmind Psychiatric Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5980 S Main St Ste 101, Clarkston, MI 48346 Phone: 248-470-7359 | |
Convo Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10167 Graham Drive, Clarkston, MI 48348 Phone: 248-805-1764 | |
Resolution Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5840 Lorac Dr Ste 5, Clarkston, MI 48346 Phone: 248-249-0989 Fax: 248-625-0945 |