| Apex Behavioral Health Dearborn Pllc | |
|
6 Parklane Blvd Suite 695 Dearborn MI 48126-2696 | |
| (313) 271-8170 | |
| (313) 271-8353 |
| Full Name | Apex Behavioral Health Dearborn Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6 Parklane Blvd, Dearborn, Michigan |
| Authorized Official Name and Position | Ghulam Qadir (CEO) |
| Authorized Official Contact | 3132718170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Apex Behavioral Health Dearborn Pllc 6 Parklane Blvd Suite 695 Dearborn MI 48126-2696 Ph: (313) 271-8170 | Apex Behavioral Health Dearborn Pllc 6 Parklane Blvd Suite 695 Dearborn MI 48126-2696 Ph: (313) 271-8170 |
| NPI Number | 1467732644 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 08/20/2011 |
| Medicare PECOS PAC ID | 7911165949 |
|---|---|
| Medicare Enrollment ID | O20120222000840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467732644 | NPI | - | NPPES |
| 6801067821 | Other | MI | LICENSE |
| 6801079069 | Other | MI | LICENSE |
| 6801091642 | Other | MI | LICENSE |
| 4301034895 | Other | MI | LICENSE |
| 4301055604 | Other | MI | LICENSE |
| 6301002147 | Other | MI | LICENSE |
| 6301003906 | Other | MI | LICENSE |
| 6801019436 | Other | MI | LICENSE |
| 4301040442 | Other | MI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301040442 (Michigan) | Primary |
| Provider Name | Huda Zenati |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356513238 PECOS PAC ID: 9931168093 Enrollment ID: I20041005001190 |
| Provider Name | Charmain R La Fountain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043368806 PECOS PAC ID: 0143281337 Enrollment ID: I20041021000194 |
| Provider Name | Ghulam Qadir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770662165 PECOS PAC ID: 7113813924 Enrollment ID: I20041124000427 |
| Provider Name | Jaime Ayala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235180720 PECOS PAC ID: 7810967601 Enrollment ID: I20050301000336 |
| Provider Name | Edgard Pedraza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881881324 PECOS PAC ID: 8820022072 Enrollment ID: I20050927000162 |
| Provider Name | Linda Shriver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679746556 PECOS PAC ID: 1658426358 Enrollment ID: I20090902000034 |
| Provider Name | Alicia Shamblin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548407141 PECOS PAC ID: 6507913167 Enrollment ID: I20100602000041 |
| Provider Name | Vijaya C Ramesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538234984 PECOS PAC ID: 7214823038 Enrollment ID: I20110309000900 |
| Provider Name | Jon L Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912170333 PECOS PAC ID: 9638337553 Enrollment ID: I20120223000744 |
| Provider Name | Mary Rose Cyril-schwartz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144535899 PECOS PAC ID: 0143488072 Enrollment ID: I20120223000801 |
| Provider Name | Moray J Wehab |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285982710 PECOS PAC ID: 6709010184 Enrollment ID: I20131018001035 |
| Provider Name | Kurtis J Lamarr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356540488 PECOS PAC ID: 8527364686 Enrollment ID: I20160316000206 |
| Provider Name | Christy Houston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811327232 PECOS PAC ID: 7719260660 Enrollment ID: I20170220001500 |
| Provider Name | Laura S Segal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437336062 PECOS PAC ID: 5395092159 Enrollment ID: I20180725000452 |
| Provider Name | Marilyn Bonem |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659830834 PECOS PAC ID: 7416299037 Enrollment ID: I20190501001932 |
| Provider Name | Kristina Hammoudeh |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1760812820 PECOS PAC ID: 5698140515 Enrollment ID: I20230406002534 |
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