| Premier Wellness Healthcare | |
|
103 N Main St Bel Air MD 21014-3539 | |
| (888) 333-1345 | |
| (888) 653-0154 |
| Full Name | Premier Wellness Healthcare |
|---|---|
| Speciality | Psychologist |
| Location | 103 N Main St, Bel Air, Maryland |
| Authorized Official Name and Position | Cynthia Dicara (OWNER) |
| Authorized Official Contact | 8883331345 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Wellness Healthcare 133 Black Oak Trl Delta PA 17314-8756 Ph: () - | Premier Wellness Healthcare 103 N Main St Bel Air MD 21014-3539 Ph: (888) 333-1345 |
| NPI Number | 1376087635 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 04/09/2019 |
| Medicare PECOS PAC ID | 1052688389 |
|---|---|
| Medicare Enrollment ID | O20170517000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376087635 | NPI | - | NPPES |
| 7635036-00 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia J Balducci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558421909 PECOS PAC ID: 9931265345 Enrollment ID: I20090311000116 |
| Provider Name | Chriselda N Fleming |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760506083 PECOS PAC ID: 2062667884 Enrollment ID: I20130228000469 |
| Provider Name | Lyubov Popivker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215256664 PECOS PAC ID: 5294088720 Enrollment ID: I20181030001235 |
| Provider Name | Rebecca Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386119121 PECOS PAC ID: 9032463518 Enrollment ID: I20201021003270 |
| Provider Name | Courtney Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265135313 PECOS PAC ID: 8921464314 Enrollment ID: I20230509001711 |
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