| Wellness Card Llc | |
|
1320 Woodman Dr Dayton OH 45432-3497 | |
| (937) 223-1781 | |
| (937) 424-8656 |
| Full Name | Wellness Card Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1320 Woodman Dr, Dayton, Ohio |
| Authorized Official Name and Position | Jeffrey Frank Kolaczkowski (OWNER/DIRECTOR) |
| Authorized Official Contact | 9372231781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Card Llc 1320 Woodman Dr Dayton OH 45432-3497 Ph: (937) 223-1781 | Wellness Card Llc 1320 Woodman Dr Dayton OH 45432-3497 Ph: (937) 223-1781 |
| NPI Number | 1558678151 |
|---|---|
| Provider Enumeration Date | 09/03/2010 |
| Last Update Date | 09/03/2010 |
| Medicare PECOS PAC ID | 6800078791 |
|---|---|
| Medicare Enrollment ID | O20110314001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558678151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kenneth D Glass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417934340 PECOS PAC ID: 7315996949 Enrollment ID: I20050201000467 |
| Provider Name | Jeffrey Frank Kolaczkowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821070137 PECOS PAC ID: 2961316989 Enrollment ID: I20050714001092 |
| Provider Name | Darshan Singh Sehbi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851370696 PECOS PAC ID: 4981634219 Enrollment ID: I20050817000073 |
| Provider Name | Charles L Walters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598745556 PECOS PAC ID: 4486779766 Enrollment ID: I20100909000721 |
| Provider Name | Shirlann D Knight |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982810198 PECOS PAC ID: 4082874474 Enrollment ID: I20120321000796 |
| Provider Name | Darrell M Guest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609853753 PECOS PAC ID: 4082869342 Enrollment ID: I20130313000123 |
| Provider Name | Cindy J Michael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609100973 PECOS PAC ID: 5597909457 Enrollment ID: I20130913000579 |
| Provider Name | Epie L Ajebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861729071 PECOS PAC ID: 3072745413 Enrollment ID: I20140416002513 |
| Provider Name | Simran Sehbi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215958582 PECOS PAC ID: 8224339601 Enrollment ID: I20151209002523 |
| Provider Name | Emily A Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548524077 PECOS PAC ID: 8628234598 Enrollment ID: I20160105002220 |
| Provider Name | Merope Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013355965 PECOS PAC ID: 6901108125 Enrollment ID: I20160105002519 |
| Provider Name | Kelly K Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134675192 PECOS PAC ID: 6608156716 Enrollment ID: I20161207001519 |
| Provider Name | Obed C Anya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245529957 PECOS PAC ID: 1153745062 Enrollment ID: I20200724002071 |
| Provider Name | Lisa Goecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427772821 PECOS PAC ID: 2769857986 Enrollment ID: I20230331000602 |
| Provider Name | Kimberly L Swartz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497425169 PECOS PAC ID: 7113384975 Enrollment ID: I20230609000447 |
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