| Team Wellness Center | |
|
2925 Russell St Detroit MI 48207-4825 | |
| (313) 396-5300 | |
| (313) 396-5353 |
| Full Name | Team Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2925 Russell St, Detroit, Michigan |
| Authorized Official Name and Position | Ashley Nicole Segrest (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3132743700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Team Wellness Center 290 Town Center Dr Ste 400 Dearborn MI 48126-2765 Ph: (313) 274-3700 | Team Wellness Center 2925 Russell St Detroit MI 48207-4825 Ph: (313) 396-5300 |
| NPI Number | 1588855100 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 06/03/2026 |
| Certification Date | 06/03/2026 |
| Medicare PECOS PAC ID | 2264451830 |
|---|---|
| Medicare Enrollment ID | O20081030000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588855100 | NPI | - | NPPES |
| 4696337 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (NU) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | (NU) | Secondary |
| Provider Name | David K Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497799951 PECOS PAC ID: 9537137195 Enrollment ID: I20040921000951 |
| Provider Name | Someswara N Navuluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669419156 PECOS PAC ID: 6507835386 Enrollment ID: I20040928001265 |
| Provider Name | Edward Roberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871611251 PECOS PAC ID: 4385603943 Enrollment ID: I20041008000173 |
| Provider Name | Carla L Hunter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689721375 PECOS PAC ID: 2264490291 Enrollment ID: I20041222000425 |
| Provider Name | Bruce K Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689638694 PECOS PAC ID: 0143270405 Enrollment ID: I20050125000851 |
| Provider Name | Christine M Post |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528161981 PECOS PAC ID: 8820040611 Enrollment ID: I20050221000540 |
| Provider Name | Katrina Denise Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053399337 PECOS PAC ID: 2961423173 Enrollment ID: I20051215000641 |
| Provider Name | John W Head |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750393690 PECOS PAC ID: 6305833534 Enrollment ID: I20061010000043 |
| Provider Name | Iris S Tucker Lloyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447330840 PECOS PAC ID: 5193723260 Enrollment ID: I20061128000260 |
| Provider Name | Hon C Chan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669420741 PECOS PAC ID: 0648272252 Enrollment ID: I20070212000322 |
| Provider Name | Ruby J Bowens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932306347 PECOS PAC ID: 7911090444 Enrollment ID: I20070829000599 |
| Provider Name | Shirley a Francis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427173558 PECOS PAC ID: 1557461357 Enrollment ID: I20070911000346 |
| Provider Name | Xavier White |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265548903 PECOS PAC ID: 8123116985 Enrollment ID: I20071113000406 |
| Provider Name | Bens J Sandaire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417156332 PECOS PAC ID: 2365344751 Enrollment ID: I20081111000132 |
| Provider Name | Daniel J Petersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740458538 PECOS PAC ID: 1759412984 Enrollment ID: I20100701000389 |
| Provider Name | Ethel Mbombow |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801121348 PECOS PAC ID: 1456475367 Enrollment ID: I20100830000719 |
| Provider Name | Gerald Tyler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780993931 PECOS PAC ID: 3779766803 Enrollment ID: I20110325000711 |
| Provider Name | Doresea Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124218466 PECOS PAC ID: 7315182979 Enrollment ID: I20130402000289 |
| Provider Name | Michelle D Sessom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134468960 PECOS PAC ID: 2860638590 Enrollment ID: I20130424000807 |
| Provider Name | Rhoddy D Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659401065 PECOS PAC ID: 5496997694 Enrollment ID: I20130819000581 |
| Provider Name | Vanita S Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861806101 PECOS PAC ID: 5799901781 Enrollment ID: I20140729000196 |
| Provider Name | Shatha I Alkatib |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376948919 PECOS PAC ID: 8022330380 Enrollment ID: I20141124001169 |
| Provider Name | Charlene Staff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245634195 PECOS PAC ID: 3072839901 Enrollment ID: I20150311001630 |
| Provider Name | Tanya Delene Mccauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053742601 PECOS PAC ID: 0446482616 Enrollment ID: I20150608001765 |
| Provider Name | Jennifer L Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215052444 PECOS PAC ID: 4688985047 Enrollment ID: I20150625002147 |
| Provider Name | Tiffany Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730572660 PECOS PAC ID: 2365763950 Enrollment ID: I20150720000074 |
| Provider Name | Dorothy P Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649514233 PECOS PAC ID: 3072816214 Enrollment ID: I20160122000480 |
| Provider Name | Evelyn E Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093000515 PECOS PAC ID: 4789987926 Enrollment ID: I20160122000514 |
| Provider Name | Torri L Elliott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114274677 PECOS PAC ID: 5597069286 Enrollment ID: I20160201000145 |
| Provider Name | Barbara L Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841636099 PECOS PAC ID: 3779877444 Enrollment ID: I20160803003121 |
| Provider Name | Gayle J Hatfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942416821 PECOS PAC ID: 4688962301 Enrollment ID: I20161013000299 |
| Provider Name | Benjamin E Burns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356605984 PECOS PAC ID: 4082914999 Enrollment ID: I20161018001971 |
| Provider Name | Pamela Obare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780040246 PECOS PAC ID: 9436437043 Enrollment ID: I20161102002371 |
| Provider Name | Krishna Jakkula |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558719906 PECOS PAC ID: 2365724614 Enrollment ID: I20170120001317 |
| Provider Name | Gwendolyn La Croix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801343942 PECOS PAC ID: 9537443742 Enrollment ID: I20170308001087 |
| Provider Name | Erin Louise Castile |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285041442 PECOS PAC ID: 6507139151 Enrollment ID: I20170905000393 |
| Provider Name | Melissa a Serra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023364635 PECOS PAC ID: 2365716412 Enrollment ID: I20170928000233 |
| Provider Name | Bushra Y Alsafari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114323060 PECOS PAC ID: 8426322579 Enrollment ID: I20171002000875 |
| Provider Name | Leon T Charette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689840936 PECOS PAC ID: 8325313042 Enrollment ID: I20171005002983 |
| Provider Name | Nalo Morant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154794311 PECOS PAC ID: 2769744234 Enrollment ID: I20180321000438 |
| Provider Name | Jeannine K Peck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245741230 PECOS PAC ID: 2466714753 Enrollment ID: I20180327000155 |
| Provider Name | Gloria Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164921839 PECOS PAC ID: 2860754173 Enrollment ID: I20180327000922 |
| Provider Name | Gregory Samuel Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558732586 PECOS PAC ID: 8628326774 Enrollment ID: I20180806001420 |
| Provider Name | Jonnika Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518440775 PECOS PAC ID: 7012252596 Enrollment ID: I20190103000882 |
| Provider Name | Sylvia M Lloyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376807628 PECOS PAC ID: 4486991486 Enrollment ID: I20190129003366 |
| Provider Name | Kimberly R Varga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508316100 PECOS PAC ID: 1456690700 Enrollment ID: I20190304001052 |
| Provider Name | Tonya Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275957185 PECOS PAC ID: 3375883408 Enrollment ID: I20190327000900 |
| Provider Name | Sara Callison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154673564 PECOS PAC ID: 8325374911 Enrollment ID: I20190718003391 |
| Provider Name | Osamuedemen Iyoha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144616079 PECOS PAC ID: 6608127170 Enrollment ID: I20191204001099 |
| Provider Name | Michael Salinas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336530252 PECOS PAC ID: 4688004690 Enrollment ID: I20200415000736 |
| Provider Name | Juanita Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184062671 PECOS PAC ID: 4587094388 Enrollment ID: I20200419000259 |
| Provider Name | Andrea Denise Motley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902240757 PECOS PAC ID: 7315362985 Enrollment ID: I20200730001745 |
| Provider Name | Lorie Ann Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194354811 PECOS PAC ID: 6002231206 Enrollment ID: I20200806003343 |
| Provider Name | Brenda L Sanders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295130144 PECOS PAC ID: 8325464084 Enrollment ID: I20200812003035 |
| Provider Name | Marisa Zenas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447893912 PECOS PAC ID: 1658799598 Enrollment ID: I20200909003026 |
| Provider Name | Sheila Hatton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215554803 PECOS PAC ID: 0941628812 Enrollment ID: I20200910000374 |
| Provider Name | Holly Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942791843 PECOS PAC ID: 3072932839 Enrollment ID: I20200925001431 |
| Provider Name | Jennifer Joann Harvey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205117637 PECOS PAC ID: 4385990845 Enrollment ID: I20201015000459 |
| Provider Name | Oula Chehab |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164995841 PECOS PAC ID: 4284044017 Enrollment ID: I20201106001887 |
| Provider Name | Eriko Apriliando |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528679305 PECOS PAC ID: 9335551688 Enrollment ID: I20201210002155 |
| Provider Name | Anna E Baur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619492071 PECOS PAC ID: 4385058460 Enrollment ID: I20210201002131 |
| Provider Name | Amy Wulke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770170649 PECOS PAC ID: 5698180966 Enrollment ID: I20210218001632 |
| Provider Name | Jamila Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437765492 PECOS PAC ID: 4880001551 Enrollment ID: I20210324001848 |
| Provider Name | Gwendolyn Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992390157 PECOS PAC ID: 6406248673 Enrollment ID: I20220120000672 |
| Provider Name | Bradley Allan Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083261705 PECOS PAC ID: 0648663419 Enrollment ID: I20220201000183 |
| Provider Name | Robert Zenas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700475779 PECOS PAC ID: 8628461555 Enrollment ID: I20220216002704 |
| Provider Name | Kathryn L Hartman-sheridan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306505151 PECOS PAC ID: 4789077611 Enrollment ID: I20220216002876 |
| Provider Name | Mariam a Abbas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982352811 PECOS PAC ID: 3577717347 Enrollment ID: I20220518000648 |
| Provider Name | Eliza Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811590185 PECOS PAC ID: 5597155408 Enrollment ID: I20220608000637 |
| Provider Name | Rawya Kazan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023743432 PECOS PAC ID: 4284018730 Enrollment ID: I20220831003794 |
| Provider Name | Diana a Escamilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811448772 PECOS PAC ID: 9335524040 Enrollment ID: I20220916000711 |
| Provider Name | Lativia D Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033453139 PECOS PAC ID: 4385011303 Enrollment ID: I20221104000453 |
| Provider Name | Suzan K Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194451518 PECOS PAC ID: 6608880562 Enrollment ID: I20221123001352 |
| Provider Name | Katrina L Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699247866 PECOS PAC ID: 4082085220 Enrollment ID: I20230125002293 |
| Provider Name | Deanna Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912631466 PECOS PAC ID: 4183080955 Enrollment ID: I20230520000288 |
| Provider Name | Ericka Magee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104468255 PECOS PAC ID: 2860851953 Enrollment ID: I20230707001346 |
| Provider Name | Antoinette D Pouokam-longmo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770144370 PECOS PAC ID: 9830550516 Enrollment ID: I20230727001570 |
| Provider Name | Candice Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548973779 PECOS PAC ID: 8325401011 Enrollment ID: I20230829000731 |
| Provider Name | Sherry L Razo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831680529 PECOS PAC ID: 9436502416 Enrollment ID: I20240125002876 |
| Provider Name | Stephanie a Keathley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548648496 PECOS PAC ID: 7315390291 Enrollment ID: I20240126002083 |
| Provider Name | Zahraa I Saab |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003487141 PECOS PAC ID: 6103279088 Enrollment ID: I20240126002241 |
| Provider Name | Jamie L Mallon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629580782 PECOS PAC ID: 6002269834 Enrollment ID: I20240129002719 |
| Provider Name | Christie R Teem |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154091551 PECOS PAC ID: 7719330240 Enrollment ID: I20240131002005 |
| Provider Name | Angela M Watley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205339041 PECOS PAC ID: 6103269816 Enrollment ID: I20240209002161 |
| Provider Name | Beverly J Frazier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083491823 PECOS PAC ID: 7416391669 Enrollment ID: I20240215003835 |
| Provider Name | Aishia S Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750688347 PECOS PAC ID: 0941645923 Enrollment ID: I20240229001769 |
| Provider Name | Randi R Charters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477101434 PECOS PAC ID: 7517303878 Enrollment ID: I20240308000610 |
| Provider Name | Iesha M Odum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689008609 PECOS PAC ID: 2062859739 Enrollment ID: I20240318002927 |
| Provider Name | Stephanie Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629380332 PECOS PAC ID: 5991143786 Enrollment ID: I20240328003155 |
| Provider Name | Lori S Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538512116 PECOS PAC ID: 1658719547 Enrollment ID: I20240411001068 |
| Provider Name | Latasha Judy Spencer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003469644 PECOS PAC ID: 0042659195 Enrollment ID: I20240422002963 |
| Provider Name | Darnella V Hankins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760039986 PECOS PAC ID: 6507205580 Enrollment ID: I20240424000498 |
| Provider Name | Tressa Henson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255770004 PECOS PAC ID: 5799019519 Enrollment ID: I20240502001912 |
| Provider Name | Cailin L Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427806926 PECOS PAC ID: 1456897461 Enrollment ID: I20240726001018 |
| Provider Name | Randia Dickerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366044653 PECOS PAC ID: 4981140746 Enrollment ID: I20240729002688 |
| Provider Name | Latonya S Shephard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609213107 PECOS PAC ID: 7012453889 Enrollment ID: I20240729002927 |
| Provider Name | Ashley M Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467817973 PECOS PAC ID: 9739546169 Enrollment ID: I20240729003405 |
| Provider Name | Mary Fillmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811715626 PECOS PAC ID: 6608396106 Enrollment ID: I20250227002265 |
| Provider Name | Gayle Renee Springer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407509359 PECOS PAC ID: 6406362235 Enrollment ID: I20250718003930 |
| Provider Name | Nwakaego Uwaezuoke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598264319 PECOS PAC ID: 6204339393 Enrollment ID: I20250913000336 |
| Provider Name | Lisa Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437969466 PECOS PAC ID: 1254834344 Enrollment ID: I20250913000522 |
| Provider Name | Michelle Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497347652 PECOS PAC ID: 2365945243 Enrollment ID: I20250915003483 |
| Provider Name | Winnie J Koima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518773241 PECOS PAC ID: 6901301027 Enrollment ID: I20250927000004 |
| Provider Name | Kamilah S Omari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588849194 PECOS PAC ID: 1153826276 Enrollment ID: I20250927000016 |
| Provider Name | Ayana L Singleton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609359678 PECOS PAC ID: 9133624257 Enrollment ID: I20250927000053 |
| Provider Name | Jonathon T Portaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982410049 PECOS PAC ID: 2860997988 Enrollment ID: I20250927000054 |
| Provider Name | Britney N Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861039679 PECOS PAC ID: 6406352939 Enrollment ID: I20251002003080 |
| Provider Name | Tiffany T Ruff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265126205 PECOS PAC ID: 4082103536 Enrollment ID: I20251027001919 |
| Provider Name | Christinia R Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437907938 PECOS PAC ID: 6406345057 Enrollment ID: I20251103000783 |
| Provider Name | Tanner Blaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457045353 PECOS PAC ID: 1658858402 Enrollment ID: I20260122003056 |
| Provider Name | Sharmese M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124995501 PECOS PAC ID: 1052889235 Enrollment ID: I20260506001193 |
| Provider Name | Amber Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245753631 PECOS PAC ID: 6406324557 Enrollment ID: I20260506003132 |
Central City Health (cherry Health) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8333 Townsend St, Detroit, MI 48213 Phone: 313-831-3160 |
Smith Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7800 W Outer Dr, Suite 230, Detroit, MI 48235 Phone: 313-535-0900 Fax: 313-535-3810 |
St. John Hospital and Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 586-753-0011 |
Chass Mack Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3426 Mack Avenue, Detroit, MI 48207 Phone: 313-849-3920 |
Soulstead Valorgrid Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14700 Tireman St Apt 2, Detroit, MI 48228 Phone: 313-439-0442 |
Ascension St John Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 586-753-0011 |