| Personal Wellness Center | |
|
106 Milford St Suite 701 Salisbury MD 21804-6953 | |
| (410) 742-6016 | |
| Not Available |
| Full Name | Personal Wellness Center |
|---|---|
| Speciality | Counselor |
| Location | 106 Milford St, Salisbury, Maryland |
| Authorized Official Name and Position | Veronica Correa (OWNER) |
| Authorized Official Contact | 4107426016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Wellness Center 106 Milford St Suite 701 Salisbury MD 21804-6953 Ph: (410) 742-6016 | Personal Wellness Center 106 Milford St Suite 701 Salisbury MD 21804-6953 Ph: (410) 742-6016 |
| NPI Number | 1093050890 |
|---|---|
| Provider Enumeration Date | 12/05/2012 |
| Last Update Date | 05/02/2013 |
| Medicare PECOS PAC ID | 7315184777 |
|---|---|
| Medicare Enrollment ID | O20130503000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093050890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 11098 (Maryland) | Primary |
| Provider Name | Enrique Olivares |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053309674 PECOS PAC ID: 2769460856 Enrollment ID: I20040713001682 |
| Provider Name | Veronica Correa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447362744 PECOS PAC ID: 4688681570 Enrollment ID: I20060317000345 |
| Provider Name | Angela M Blake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891882577 PECOS PAC ID: 2264535244 Enrollment ID: I20070312000507 |
| Provider Name | Carol L Ireland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932329455 PECOS PAC ID: 6800059072 Enrollment ID: I20120525000439 |
| Provider Name | Sandra A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245586122 PECOS PAC ID: 1557511060 Enrollment ID: I20121018000312 |
| Provider Name | Venessa Ann Bowers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164720124 PECOS PAC ID: 6305074907 Enrollment ID: I20150513001176 |
| Provider Name | Mehryar Tabib |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295776698 PECOS PAC ID: 9931196953 Enrollment ID: I20160128002548 |
| Provider Name | Danielle Boyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063863173 PECOS PAC ID: 5092067199 Enrollment ID: I20181017001760 |
| Provider Name | Kathleen Patricia Maycock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659550507 PECOS PAC ID: 8921349069 Enrollment ID: I20190417002930 |
| Provider Name | Ciara Cooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639514631 PECOS PAC ID: 6800120122 Enrollment ID: I20190620000746 |
| Provider Name | Jamie Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992236491 PECOS PAC ID: 0941634380 Enrollment ID: I20191218001171 |
| Provider Name | Whitney Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104454701 PECOS PAC ID: 9931516705 Enrollment ID: I20210323000050 |
| Provider Name | Sabrina A Sahle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295314276 PECOS PAC ID: 6305255324 Enrollment ID: I20210504001081 |
| Provider Name | Kimberly Linton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770160392 PECOS PAC ID: 9638576101 Enrollment ID: I20210927000385 |
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