| Bay Mental Health Llc | |
|
10331 Dawsons Creek Blvd Ste D Fort Wayne IN 46825-1908 | |
| (260) 525-5807 | |
| Not Available |
| Full Name | Bay Mental Health Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10331 Dawsons Creek Blvd Ste D, Fort Wayne, Indiana |
| Authorized Official Name and Position | Thaddeus James Bay (THERAPIST/OWNER) |
| Authorized Official Contact | 2602426643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Mental Health Llc 312 Old Bog Rd Avilla IN 46710-9458 Ph: (260) 242-6643 | Bay Mental Health Llc 10331 Dawsons Creek Blvd Ste D Fort Wayne IN 46825-1908 Ph: (260) 525-5807 |
| NPI Number | 1972241925 |
|---|---|
| Provider Enumeration Date | 05/20/2022 |
| Last Update Date | 05/20/2022 |
| Certification Date | 05/20/2022 |
| Medicare PECOS PAC ID | 5698159440 |
|---|---|
| Medicare Enrollment ID | O20220829002305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972241925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Thaddeus J Bay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154933216 PECOS PAC ID: 5698193647 Enrollment ID: I20200908003163 |
| Provider Name | Kaitlyn M Pozorski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700469657 PECOS PAC ID: 9032518949 Enrollment ID: I20210526001353 |
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