| Spectracare Health Systems, Inc. | |
|
134 Prevatt Rd Dothan AL 36301-5427 | |
| (334) 794-0731 | |
| (334) 671-9199 |
| Full Name | Spectracare Health Systems, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 134 Prevatt Rd, Dothan, Alabama |
| Authorized Official Name and Position | Melissa Kirkland (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3347122720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectracare Health Systems, Inc. Po Box 1245 2694 South Park Ave. Dothan AL 36302-1245 Ph: (334) 712-2720 | Spectracare Health Systems, Inc. 134 Prevatt Rd Dothan AL 36301-5427 Ph: (334) 794-0731 |
| NPI Number | 1215990734 |
|---|---|
| Provider Enumeration Date | 04/07/2006 |
| Last Update Date | 11/28/2012 |
| Medicare PECOS PAC ID | 3779509765 |
|---|---|
| Medicare Enrollment ID | O20051019000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215990734 | NPI | - | NPPES |
| 331000069 | Medicaid | AL | |
| 331000467 | Medicaid | AL | |
| 059726100 | Medicaid | FL | |
| 330034010 | Medicaid | AL | |
| 51003550 | Other | AL | COMMERCIAL INSURANCE |
| 008412000 | Medicaid | AL | |
| 331600592 | Medicaid | AL | |
| 591600003 | Medicaid | AL | |
| 008301620 | Medicaid | AL | |
| 330000010 | Medicaid | AL | |
| 33000010 | Medicaid | AL | |
| 331000067 | Medicaid | AL | |
| 51043903 | Other | AL | BLUE CROSS BLUE SHIELD |
| 590000010 | Medicaid | AL | |
| 591500003 | Medicaid | AL | |
| 331600587 | Medicaid | AL |
| Provider Name | Fernando Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659391951 PECOS PAC ID: 7810980950 Enrollment ID: I20040406000094 |
| Provider Name | Bobby Stephen Sanders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174790299 PECOS PAC ID: 5991869810 Enrollment ID: I20090121000469 |
| Provider Name | Esiri Esin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013147990 PECOS PAC ID: 4284778259 Enrollment ID: I20100927000264 |
| Provider Name | Danielle Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679114532 PECOS PAC ID: 0345672838 Enrollment ID: I20191121003154 |
| Provider Name | Amanda Louise Baine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528663275 PECOS PAC ID: 0648685008 Enrollment ID: I20210216003240 |
| Provider Name | Bobbi Houston Pippins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891485173 PECOS PAC ID: 8628434123 Enrollment ID: I20230524003273 |
| Provider Name | Brittnee Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407546021 PECOS PAC ID: 9537527148 Enrollment ID: I20230614000249 |
| Provider Name | Jenny Lee Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811644503 PECOS PAC ID: 8527429349 Enrollment ID: I20230726002626 |
| Provider Name | Tabitha England |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861932063 PECOS PAC ID: 2961851662 Enrollment ID: I20231206002827 |
| Provider Name | Kenna Miranda Walters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689346934 PECOS PAC ID: 0244689644 Enrollment ID: I20231211002589 |
| Provider Name | Kimberly Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699235440 PECOS PAC ID: 8426401472 Enrollment ID: I20240126000484 |
| Provider Name | Carrie Mega |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750855714 PECOS PAC ID: 8820441199 Enrollment ID: I20240202001275 |
| Provider Name | Daphne Dufrene Wilde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871132886 PECOS PAC ID: 1254774417 Enrollment ID: I20240205004339 |
| Provider Name | Lisa Barry Fuller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407407372 PECOS PAC ID: 0345684197 Enrollment ID: I20240220002272 |
| Provider Name | Cynthia Woodall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356782981 PECOS PAC ID: 8921443730 Enrollment ID: I20240304000913 |
| Provider Name | Christopher Hobbie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295409993 PECOS PAC ID: 3375989866 Enrollment ID: I20240306003596 |
| Provider Name | Maria King |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164921565 PECOS PAC ID: 2163868530 Enrollment ID: I20240307001535 |
| Provider Name | Stephanie Michelle Potter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013670462 PECOS PAC ID: 0446696793 Enrollment ID: I20240309000621 |
| Provider Name | Kelli Nicole Beaty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437933348 PECOS PAC ID: 7315384310 Enrollment ID: I20240326003694 |
| Provider Name | Lisa Colvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639937840 PECOS PAC ID: 8325488604 Enrollment ID: I20240503000914 |
| Provider Name | Nicole Anne Godwin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396585824 PECOS PAC ID: 4688118102 Enrollment ID: I20240626000107 |
Sanctuary Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1450 Ross Clark Cir, Dothan, AL 36301 Phone: 334-794-2113 | |
Dothan Neurology Clinic, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4300 W Main St, Suite 102, Dothan, AL 36305 Phone: 334-793-9564 Fax: 334-671-8907 | |
Wiregrass Wellness Center, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 201 Regency Ct, Dothan, AL 36305 Phone: 334-673-8869 Fax: 334-673-8851 | |
Houston County Healthcare Authority Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 Ross Clark Cir, Dothan, AL 36301 Phone: 334-793-8111 Fax: 334-793-8147 | |
Life Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 S Foster St, Dothan, AL 36301 Phone: 719-684-6715 | |
Professional Resource Management Of Wiregrass, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2812 Hartford Hwy Ste 1, Dothan, AL 36305 Phone: 334-712-1170 Fax: 334-460-8391 | |
Dothan Neurodiagnostic Center Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Fairview Ave, Suite 1, Dothan, AL 36301 Phone: 334-793-1703 Fax: 334-793-9314 |