| Whitesell And Associates, Inc | |
| 
					900 S Main St Bldg A Suite 105 Bel Air MD 21014-5447  | |
| (410) 914-4012 | |
| (443) 817-0808 | 
| Full Name | Whitesell And Associates, Inc | 
|---|---|
| Speciality | Counselor | 
| Location | 900 S Main St Bldg A, Bel Air, Maryland | 
| Authorized Official Name and Position | Lisa Early (CLINICAL DIRECTOR) | 
| Authorized Official Contact | 4109144012 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Whitesell And Associates, Inc 900a South Main Street Suite 105 Bel Air MD 21014 Ph: (410) 914-4012  | Whitesell And Associates, Inc 900 S Main St Bldg A Suite 105 Bel Air MD 21014-5447 Ph: (410) 914-4012  | 
| NPI Number | 1407194905 | 
|---|---|
| Provider Enumeration Date | 01/18/2013 | 
| Last Update Date | 03/14/2023 | 
| Certification Date | 03/14/2023 | 
| Medicare PECOS PAC ID | 4385911247 | 
|---|---|
| Medicare Enrollment ID | O20170524001202 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1407194905 | NPI | - | NPPES | 
| 0167800 | Medicaid | MD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary | 
| 101YP2500X | Counselor - Professional | LC0793 (Maryland) | Primary | 
| Provider Name | Robert S Pinkus | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1710078605 PECOS PAC ID: 8426068362 Enrollment ID: I20060421000524  | 
| Provider Name | Christina M Jensema | 
|---|---|
| Provider Type | Practitioner - Clinical Psychologist | 
| Provider Identifiers | NPI Number: 1215050661 PECOS PAC ID: 4789717471 Enrollment ID: I20100802000580  | 
| Provider Name | Anastasia Hope Teng | 
|---|---|
| Provider Type | Practitioner - Clinical Psychologist | 
| Provider Identifiers | NPI Number: 1518336171 PECOS PAC ID: 0143530709 Enrollment ID: I20170616000101  | 
| Provider Name | Cecilia Chanda | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1154904183 PECOS PAC ID: 7719375237 Enrollment ID: I20231104000423  | 
| Provider Name | Shakena Lasheba Mabry | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1801593439 PECOS PAC ID: 5193252039 Enrollment ID: I20241217001841  | 
| Provider Name | Monika Emma Preston | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1215275060 PECOS PAC ID: 7719414929 Enrollment ID: I20241231000007  | 
| Provider Name | Shaneika Coranada Lovelace | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1518259761 PECOS PAC ID: 2860662632 Enrollment ID: I20250102002634  | 
| Provider Name | Kelly Kiederer | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1184740185 PECOS PAC ID: 1153859400 Enrollment ID: I20250114002280  | 
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