| Northlake Physicians Group | |
|
23699 Quail Lane Mandeville LA 70448-7334 | |
| (985) 334-4040 | |
| (985) 626-6549 |
| Full Name | Northlake Physicians Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 23699 Quail Lane, Mandeville, Louisiana |
| Authorized Official Name and Position | Tony Shir (OFFICER) |
| Authorized Official Contact | 8474524565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northlake Physicians Group 7300 N Cicero Ave Suite 211 Lincolnwood IL 60712-1641 Ph: (224) 392-9889 | Northlake Physicians Group 23699 Quail Lane Mandeville LA 70448-7334 Ph: (985) 334-4040 |
| NPI Number | 1154855781 |
|---|---|
| Provider Enumeration Date | 04/20/2017 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Medicare PECOS PAC ID | 9739457342 |
|---|---|
| Medicare Enrollment ID | O20170622000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154855781 | NPI | - | NPPES |
| Provider Name | Michael James Prejean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215087887 PECOS PAC ID: 0042264574 Enrollment ID: I20050308001057 |
| Provider Name | Shanta Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427468503 PECOS PAC ID: 9436379922 Enrollment ID: I20141006000376 |
| Provider Name | Graham L Spruiell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083683130 PECOS PAC ID: 9739197625 Enrollment ID: I20161109000481 |
| Provider Name | Tyler Trenton Wansley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962035964 PECOS PAC ID: 4486079050 Enrollment ID: I20200730001845 |
| Provider Name | Sauntrice O'quin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194246686 PECOS PAC ID: 3870850563 Enrollment ID: I20201118000548 |
| Provider Name | Erik N Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043714884 PECOS PAC ID: 3072860477 Enrollment ID: I20220928002104 |
| Provider Name | Ashley Navarre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376257006 PECOS PAC ID: 6901242973 Enrollment ID: I20240422001718 |
| Provider Name | Alisha Francis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114285681 PECOS PAC ID: 2668900598 Enrollment ID: I20250106003182 |
| Provider Name | Dena Mason Theriot |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912471335 PECOS PAC ID: 5496284929 Enrollment ID: I20250128003323 |
Lurline Smith Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Wilkinson St, Mandeville, LA 70448 Phone: 985-624-4450 | |
Dr Pete Cooper Phd Lpc-s Clc Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 N Causeway Blvd Fl 2, Mandeville, LA 70471 Phone: 985-777-3184 | |
C Hope Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1402 N Causeway Blvd, Apt. 608, Mandeville, LA 70471 Phone: 770-743-7055 | |
Ness Healthcare Nfp Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 23515 Hwy 190, Mandeville, LA 70448 Phone: 847-452-4585 Fax: 985-626-6559 | |
Northlake Medical Psychology And Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Saint Ann Dr Ste 2, Mandeville, LA 70471 Phone: 601-946-1844 | |
Northshore Zen Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 N Causeway Blvd Ste B, Mandeville, LA 70471 Phone: 985-882-1322 Fax: 985-809-6909 | |
Lifenet Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4070 Lonesome Rd, Suite B, Mandeville, LA 70448 Phone: 985-246-2600 Fax: 985-246-2601 |