| Baycare Behavioral Health Associates Llc | |
|
21808 State Road 54 Lutz FL 33549-6923 | |
| (727) 315-6974 | |
| (813) 635-2613 |
| Full Name | Baycare Behavioral Health Associates Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 21808 State Road 54, Lutz, Florida |
| Authorized Official Name and Position | Lynda Gorken (VP) |
| Authorized Official Contact | 7272819202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baycare Behavioral Health Associates Llc Po Box 744253 Atlanta GA 30374-4253 Ph: (727) 281-9202 | Baycare Behavioral Health Associates Llc 21808 State Road 54 Lutz FL 33549-6923 Ph: (727) 315-6974 |
| NPI Number | 1245502152 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 02/03/2023 |
| Certification Date | 02/03/2023 |
| Medicare PECOS PAC ID | 2567624836 |
|---|---|
| Medicare Enrollment ID | O20120502000477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245502152 | NPI | - | NPPES |
| 004874800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Florida) | Primary |
| Provider Name | Jeanne R Botz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508825407 PECOS PAC ID: 5991690182 Enrollment ID: I20040217000636 |
| Provider Name | Elizabeth Ann Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295757490 PECOS PAC ID: 2567351331 Enrollment ID: I20040311000690 |
| Provider Name | Guido Nodal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427064435 PECOS PAC ID: 7911999404 Enrollment ID: I20040402000684 |
| Provider Name | Mary E Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114139581 PECOS PAC ID: 4082687223 Enrollment ID: I20040817000250 |
| Provider Name | Tracey E Smithey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629088455 PECOS PAC ID: 7618946534 Enrollment ID: I20040928000754 |
| Provider Name | Srinivas Yerneni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871552570 PECOS PAC ID: 9739074923 Enrollment ID: I20041007000515 |
| Provider Name | Joseph D Fishel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639215288 PECOS PAC ID: 8921069873 Enrollment ID: I20041023000091 |
| Provider Name | Edwin W Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740294883 PECOS PAC ID: 6103879341 Enrollment ID: I20050228000541 |
| Provider Name | Rhonda R Lampen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760412621 PECOS PAC ID: 2163477308 Enrollment ID: I20050321000549 |
| Provider Name | George C Winny |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942217492 PECOS PAC ID: 9537105499 Enrollment ID: I20050630000321 |
| Provider Name | Ayman G Hanna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275567026 PECOS PAC ID: 9537101449 Enrollment ID: I20051205000102 |
| Provider Name | Mark Sinz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366523078 PECOS PAC ID: 6901827518 Enrollment ID: I20051212000177 |
| Provider Name | Nestor E Milian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407828262 PECOS PAC ID: 2163438557 Enrollment ID: I20060222000279 |
| Provider Name | Susan F Hanna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073522983 PECOS PAC ID: 4183728561 Enrollment ID: I20070323000300 |
| Provider Name | Renee C Tapasak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477611200 PECOS PAC ID: 5597861252 Enrollment ID: I20070426000435 |
| Provider Name | Mary Ann Zigouris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043343494 PECOS PAC ID: 1658477336 Enrollment ID: I20070427000030 |
| Provider Name | Janet Waye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043433741 PECOS PAC ID: 5395837611 Enrollment ID: I20070816000339 |
| Provider Name | Mary E Lowrey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619076080 PECOS PAC ID: 1850485392 Enrollment ID: I20070914000436 |
| Provider Name | Takkallapelli D Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679552434 PECOS PAC ID: 2062445844 Enrollment ID: I20071101000637 |
| Provider Name | Valeria L Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235326067 PECOS PAC ID: 5496842700 Enrollment ID: I20071102000647 |
| Provider Name | Michele Weintraub |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679514129 PECOS PAC ID: 5991690554 Enrollment ID: I20071129000556 |
| Provider Name | Karen Severson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689787426 PECOS PAC ID: 0840364030 Enrollment ID: I20080806000401 |
| Provider Name | Shabu Varghese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649499641 PECOS PAC ID: 0042379562 Enrollment ID: I20081112000453 |
| Provider Name | Troy D Howell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326237348 PECOS PAC ID: 8921168253 Enrollment ID: I20081117000616 |
| Provider Name | Pamela D Sherwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043305857 PECOS PAC ID: 5193707834 Enrollment ID: I20090409000559 |
| Provider Name | Nasreen Razack-malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982732707 PECOS PAC ID: 6507916376 Enrollment ID: I20090617000183 |
| Provider Name | Debbie Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205849890 PECOS PAC ID: 5991857732 Enrollment ID: I20090709000116 |
| Provider Name | Don Alan Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386653129 PECOS PAC ID: 1456404367 Enrollment ID: I20090724000306 |
| Provider Name | Paul R Hebig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871765768 PECOS PAC ID: 0446306864 Enrollment ID: I20090925000270 |
| Provider Name | Efrain Mendez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871640847 PECOS PAC ID: 2961591235 Enrollment ID: I20091103000132 |
| Provider Name | Kirtikumar J Pandya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568408870 PECOS PAC ID: 6800936113 Enrollment ID: I20091217000474 |
| Provider Name | Meenakshi M Mohan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811905763 PECOS PAC ID: 3173665213 Enrollment ID: I20100127000612 |
| Provider Name | Tanya E. Tucker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346418159 PECOS PAC ID: 6800911975 Enrollment ID: I20100913000658 |
| Provider Name | Lauren Berrios |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881902120 PECOS PAC ID: 4688851223 Enrollment ID: I20110607000571 |
| Provider Name | Gnaneswara Midathala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750393237 PECOS PAC ID: 1052392826 Enrollment ID: I20110715000611 |
| Provider Name | Kimberly E Hartney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245401280 PECOS PAC ID: 4789718743 Enrollment ID: I20110812000496 |
| Provider Name | Patricia Hess |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669669826 PECOS PAC ID: 1153406517 Enrollment ID: I20110812000673 |
| Provider Name | Arline M Kenneth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386835163 PECOS PAC ID: 0547430894 Enrollment ID: I20110824000824 |
| Provider Name | Silvia Fernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740447358 PECOS PAC ID: 4486726445 Enrollment ID: I20111101000325 |
| Provider Name | Jason B Fields |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639289101 PECOS PAC ID: 5496912230 Enrollment ID: I20120206000473 |
| Provider Name | Praveen K Gootam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417148610 PECOS PAC ID: 9234398447 Enrollment ID: I20120307000800 |
| Provider Name | Jennifer M Gonatos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144534835 PECOS PAC ID: 1153513197 Enrollment ID: I20120412000302 |
| Provider Name | Almari Ginory |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265624316 PECOS PAC ID: 8022271386 Enrollment ID: I20120523000720 |
| Provider Name | Onelia H Ramirez-cook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669639001 PECOS PAC ID: 5193989226 Enrollment ID: I20120620000834 |
| Provider Name | Marnie Stefan Acta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336301753 PECOS PAC ID: 7012163231 Enrollment ID: I20120803000250 |
| Provider Name | Sarah Mcmillen Fayad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528225232 PECOS PAC ID: 1759537590 Enrollment ID: I20120809000391 |
| Provider Name | Kinshuk Bose |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598925497 PECOS PAC ID: 7517116700 Enrollment ID: I20121003000516 |
| Provider Name | Brie A Pulas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780844720 PECOS PAC ID: 4385894682 Enrollment ID: I20121023000198 |
| Provider Name | Lauren D Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508872516 PECOS PAC ID: 6901059377 Enrollment ID: I20130115000196 |
| Provider Name | Monica M Seiger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568539757 PECOS PAC ID: 0345335238 Enrollment ID: I20130502000258 |
| Provider Name | Gabrielle Ann Buettow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255349106 PECOS PAC ID: 7416194659 Enrollment ID: I20130508000135 |
| Provider Name | Renee E Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386986016 PECOS PAC ID: 5991945842 Enrollment ID: I20130717000478 |
| Provider Name | Avtar Singh Saran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245332675 PECOS PAC ID: 1759362064 Enrollment ID: I20131021001292 |
| Provider Name | Julia B Trice |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285747766 PECOS PAC ID: 7517969231 Enrollment ID: I20131120001218 |
| Provider Name | Luis A Franco |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720048812 PECOS PAC ID: 3173552981 Enrollment ID: I20140210000118 |
| Provider Name | Sabih Kayan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851325864 PECOS PAC ID: 3072744515 Enrollment ID: I20140325002076 |
| Provider Name | Dana B Harbison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659477891 PECOS PAC ID: 8325013394 Enrollment ID: I20140401000085 |
| Provider Name | Claire E Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013930205 PECOS PAC ID: 6406079607 Enrollment ID: I20140515000822 |
| Provider Name | John Young |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649244773 PECOS PAC ID: 8426080573 Enrollment ID: I20140725001307 |
| Provider Name | Maykel Luna Concepcion |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083841852 PECOS PAC ID: 8224297155 Enrollment ID: I20140729000748 |
| Provider Name | Jarryd D. Lunger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407260565 PECOS PAC ID: 3476771627 Enrollment ID: I20140829000743 |
| Provider Name | Cathleen A Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023297678 PECOS PAC ID: 5698855880 Enrollment ID: I20140925001765 |
| Provider Name | Richard Allan Callahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215378336 PECOS PAC ID: 4587886221 Enrollment ID: I20141112001350 |
| Provider Name | Sarah E Shirina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003218769 PECOS PAC ID: 0547482069 Enrollment ID: I20141117000672 |
| Provider Name | Kamal R Pathak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306130406 PECOS PAC ID: 2062736499 Enrollment ID: I20150113001778 |
| Provider Name | Gurkiran Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194967216 PECOS PAC ID: 9931425915 Enrollment ID: I20150310001990 |
| Provider Name | Darcy Ann Martin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225059710 PECOS PAC ID: 9739104712 Enrollment ID: I20150324000899 |
| Provider Name | Peter J Clagnaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043256605 PECOS PAC ID: 2466535240 Enrollment ID: I20150608002521 |
| Provider Name | Adrienne R Eisner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144514605 PECOS PAC ID: 5395988950 Enrollment ID: I20150721003213 |
| Provider Name | Sachin Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104109990 PECOS PAC ID: 0648588103 Enrollment ID: I20151001002801 |
| Provider Name | San K Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821382730 PECOS PAC ID: 0345483681 Enrollment ID: I20151014001765 |
| Provider Name | Ana Suarez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164706404 PECOS PAC ID: 8921317819 Enrollment ID: I20151015001008 |
| Provider Name | Trina H Webb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336227693 PECOS PAC ID: 1153593660 Enrollment ID: I20151020001382 |
| Provider Name | Richard A Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699903641 PECOS PAC ID: 6709186281 Enrollment ID: I20151207000805 |
| Provider Name | Ghazanfar Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437327756 PECOS PAC ID: 9537326806 Enrollment ID: I20160119000563 |
| Provider Name | Renata Angelini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720249030 PECOS PAC ID: 2860667565 Enrollment ID: I20160211001034 |
| Provider Name | Endra Sookoor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386933158 PECOS PAC ID: 3577868934 Enrollment ID: I20160223000531 |
| Provider Name | Suzanne Yoder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790809051 PECOS PAC ID: 8921072885 Enrollment ID: I20160628001107 |
| Provider Name | Pradeep D Marballi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760557797 PECOS PAC ID: 5193898617 Enrollment ID: I20160726001878 |
| Provider Name | Kazi F Hossain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588920011 PECOS PAC ID: 8224328448 Enrollment ID: I20160801000291 |
| Provider Name | Rachel Rohaidy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730475823 PECOS PAC ID: 3375838980 Enrollment ID: I20160822001758 |
| Provider Name | Brandon J Deliberato |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770882011 PECOS PAC ID: 6800019498 Enrollment ID: I20160823002956 |
| Provider Name | Jing Bu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699905091 PECOS PAC ID: 5597992602 Enrollment ID: I20161026000862 |
| Provider Name | Yasna J Heravi-burgos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881997161 PECOS PAC ID: 3072836972 Enrollment ID: I20161107002246 |
| Provider Name | Matthew C Ferrara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326480294 PECOS PAC ID: 2163701129 Enrollment ID: I20161115000129 |
| Provider Name | Arvinder Pal Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700117405 PECOS PAC ID: 5890819833 Enrollment ID: I20161129001037 |
| Provider Name | Marcus L Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740736537 PECOS PAC ID: 0547540247 Enrollment ID: I20161215002312 |
| Provider Name | David E Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013061530 PECOS PAC ID: 5890948657 Enrollment ID: I20161221001823 |
| Provider Name | Mark L Catterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902997968 PECOS PAC ID: 7517909336 Enrollment ID: I20170104000731 |
| Provider Name | Svetlana Zoueva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992998009 PECOS PAC ID: 1052571619 Enrollment ID: I20170309000362 |
| Provider Name | Kristie Jetter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750624805 PECOS PAC ID: 2264718931 Enrollment ID: I20170411002648 |
| Provider Name | Haider Shahid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598184145 PECOS PAC ID: 0244517753 Enrollment ID: I20170511000542 |
| Provider Name | Simone M Clement Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952853129 PECOS PAC ID: 2264709732 Enrollment ID: I20170605001773 |
| Provider Name | Radhika Sriram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639217193 PECOS PAC ID: 4385620293 Enrollment ID: I20170606003133 |
| Provider Name | Laura Maria Rodriguez-roman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114365822 PECOS PAC ID: 4880838309 Enrollment ID: I20170817002811 |
| Provider Name | Amy J Tower |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376633651 PECOS PAC ID: 2860652575 Enrollment ID: I20170925001145 |
| Provider Name | Kelly Spence |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831489657 PECOS PAC ID: 2567768609 Enrollment ID: I20170929002281 |
| Provider Name | Zoe Lorca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306297866 PECOS PAC ID: 2466727847 Enrollment ID: I20171011001505 |
| Provider Name | Tg Sriram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518937309 PECOS PAC ID: 8921097205 Enrollment ID: I20171118000115 |
| Provider Name | Amy M Hernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912315714 PECOS PAC ID: 9830457258 Enrollment ID: I20171212002918 |
| Provider Name | Ogugua Anene Maidoh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609212000 PECOS PAC ID: 3173881067 Enrollment ID: I20171226000711 |
| Provider Name | Elisabeth G Benovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811407562 PECOS PAC ID: 0941569263 Enrollment ID: I20180112001099 |
| Provider Name | Kelly J Rosario |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215442165 PECOS PAC ID: 1456610443 Enrollment ID: I20180119002403 |
| Provider Name | Crystal M Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407294184 PECOS PAC ID: 8820222474 Enrollment ID: I20180126001382 |
| Provider Name | Jennifer A Jackson-wohl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518939362 PECOS PAC ID: 4688664022 Enrollment ID: I20180205001596 |
| Provider Name | Jennifer L Geigan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124522289 PECOS PAC ID: 8921362443 Enrollment ID: I20180510000223 |
| Provider Name | Harold A Levine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184079998 PECOS PAC ID: 4587928726 Enrollment ID: I20180516000356 |
| Provider Name | Saraswathi Tirumalasetty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821006172 PECOS PAC ID: 1355606401 Enrollment ID: I20180521002051 |
| Provider Name | Gregory P Arthmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417394982 PECOS PAC ID: 0749401107 Enrollment ID: I20180709000786 |
| Provider Name | Lulu S Tsai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811109952 PECOS PAC ID: 2365335767 Enrollment ID: I20180719000798 |
| Provider Name | Marc Ettensohn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861753899 PECOS PAC ID: 9133355563 Enrollment ID: I20181110000181 |
| Provider Name | Britani M Lalone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619418225 PECOS PAC ID: 3678845252 Enrollment ID: I20190225001729 |
| Provider Name | Debra L Stibick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588641666 PECOS PAC ID: 4385649193 Enrollment ID: I20190318000703 |
| Provider Name | Gabriel Sanchez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235525783 PECOS PAC ID: 4789917840 Enrollment ID: I20190605002103 |
| Provider Name | Terri M Belanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801954847 PECOS PAC ID: 7719938224 Enrollment ID: I20190610000938 |
| Provider Name | Melanie L Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215335922 PECOS PAC ID: 9537492277 Enrollment ID: I20190611002838 |
| Provider Name | Pavel Sigel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619384906 PECOS PAC ID: 6103174198 Enrollment ID: I20190625002230 |
| Provider Name | Wil E Germain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720348592 PECOS PAC ID: 2668791963 Enrollment ID: I20190625003031 |
| Provider Name | Lisa M Moser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700368123 PECOS PAC ID: 4183687213 Enrollment ID: I20190731000427 |
| Provider Name | Newton Agrawal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023376936 PECOS PAC ID: 3274862826 Enrollment ID: I20190909000751 |
| Provider Name | Alfredo Gutierrez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871937391 PECOS PAC ID: 5496018939 Enrollment ID: I20191125000754 |
| Provider Name | Kayla Hobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528605896 PECOS PAC ID: 9830523620 Enrollment ID: I20200103000697 |
| Provider Name | Nicole A Millar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710123435 PECOS PAC ID: 6507292133 Enrollment ID: I20200130001237 |
| Provider Name | Amanda E Humphries |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245684422 PECOS PAC ID: 4981025384 Enrollment ID: I20200610000670 |
| Provider Name | Diego Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548605751 PECOS PAC ID: 6507115326 Enrollment ID: I20200625000643 |
| Provider Name | Ahmed Qureshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497166656 PECOS PAC ID: 3678799798 Enrollment ID: I20200626001625 |
| Provider Name | Lisa A Dush |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881193456 PECOS PAC ID: 8921421348 Enrollment ID: I20200701003043 |
| Provider Name | Charteye Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699399691 PECOS PAC ID: 4688098577 Enrollment ID: I20200724001284 |
| Provider Name | William Thomas Manley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811514342 PECOS PAC ID: 8921423310 Enrollment ID: I20200731002469 |
| Provider Name | Maureen Mansour |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801230644 PECOS PAC ID: 4789988098 Enrollment ID: I20200811000432 |
| Provider Name | Kehinde Adesokan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164871687 PECOS PAC ID: 8123448081 Enrollment ID: I20201014001099 |
| Provider Name | Pamela Pedroncelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497981310 PECOS PAC ID: 7416867478 Enrollment ID: I20201021000918 |
| Provider Name | Ali M Metheney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235661935 PECOS PAC ID: 5092135517 Enrollment ID: I20201021001796 |
| Provider Name | Jovan S Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437765153 PECOS PAC ID: 0547670804 Enrollment ID: I20201028001056 |
| Provider Name | Shivam Dubey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073764577 PECOS PAC ID: 8325298755 Enrollment ID: I20201113000115 |
| Provider Name | Taiwo H Emiola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740729334 PECOS PAC ID: 9234543117 Enrollment ID: I20210204001858 |
| Provider Name | Rowdy J Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336612779 PECOS PAC ID: 0547508244 Enrollment ID: I20210309003104 |
| Provider Name | David M Hanrahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033347125 PECOS PAC ID: 2163835398 Enrollment ID: I20210324001509 |
| Provider Name | Aaron Slone Jeckell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598031957 PECOS PAC ID: 9739482381 Enrollment ID: I20210414001407 |
| Provider Name | Ruby Abraham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083620124 PECOS PAC ID: 9931167376 Enrollment ID: I20210429000217 |
| Provider Name | Daniel W Bradford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851350326 PECOS PAC ID: 3173543725 Enrollment ID: I20210504000909 |
| Provider Name | Mary Fahrmeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245252303 PECOS PAC ID: 4880657527 Enrollment ID: I20210504001869 |
| Provider Name | Nicole Silva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205250750 PECOS PAC ID: 1951710805 Enrollment ID: I20210506000904 |
| Provider Name | Darina V Carcerano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902385008 PECOS PAC ID: 7416207568 Enrollment ID: I20210517001158 |
| Provider Name | Mark Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730263617 PECOS PAC ID: 5991855330 Enrollment ID: I20210519003031 |
| Provider Name | Elton J Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679526784 PECOS PAC ID: 1759487614 Enrollment ID: I20210602000558 |
| Provider Name | Courtney A Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720686884 PECOS PAC ID: 6507266731 Enrollment ID: I20210610000130 |
| Provider Name | Brenda G Burnett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043743982 PECOS PAC ID: 0042597031 Enrollment ID: I20210716001170 |
| Provider Name | Jamie Lorraine Evans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962664789 PECOS PAC ID: 6901044379 Enrollment ID: I20210804003007 |
| Provider Name | Dawit Amare |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992959555 PECOS PAC ID: 5395916001 Enrollment ID: I20210819000467 |
| Provider Name | Christopher Burky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043330970 PECOS PAC ID: 8729054929 Enrollment ID: I20210907000466 |
| Provider Name | James E Butler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104118918 PECOS PAC ID: 5799067237 Enrollment ID: I20210916002340 |
| Provider Name | Vicky Chodha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366884751 PECOS PAC ID: 3577853522 Enrollment ID: I20211005000128 |
| Provider Name | Marissa Stridiron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154635811 PECOS PAC ID: 2668664251 Enrollment ID: I20211007001858 |
| Provider Name | Bruno Perossa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346657889 PECOS PAC ID: 5092934513 Enrollment ID: I20211028001291 |
| Provider Name | Amit Kurani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770707986 PECOS PAC ID: 7719078286 Enrollment ID: I20211102002710 |
| Provider Name | Zoila Jarquin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457022097 PECOS PAC ID: 1052700200 Enrollment ID: I20211110000927 |
| Provider Name | Rami Abukamil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346685286 PECOS PAC ID: 9335440577 Enrollment ID: I20211112001293 |
| Provider Name | Alice Mckinzie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720025075 PECOS PAC ID: 7012261167 Enrollment ID: I20211115000899 |
| Provider Name | Adam Stivala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467738617 PECOS PAC ID: 7315376910 Enrollment ID: I20211118000306 |
| Provider Name | Sandeep S Saran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033538459 PECOS PAC ID: 8123432861 Enrollment ID: I20211202001671 |
| Provider Name | Patrick Casey Lorenz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184773509 PECOS PAC ID: 9436549359 Enrollment ID: I20211208003390 |
| Provider Name | Usama Ahmad Rafique |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629463369 PECOS PAC ID: 3274871223 Enrollment ID: I20211215001661 |
| Provider Name | Kodjovi Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20220108000059 |
| Provider Name | Douglas M Ikelheimer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508979519 PECOS PAC ID: 1759347396 Enrollment ID: I20220112001848 |
| Provider Name | Chedelie Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083294375 PECOS PAC ID: 2365835196 Enrollment ID: I20220131001240 |
| Provider Name | Lennox Kai-zoen Din |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952862492 PECOS PAC ID: 0143615856 Enrollment ID: I20220316001159 |
| Provider Name | Christiana Hope Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528714177 PECOS PAC ID: 5991190555 Enrollment ID: I20220317000019 |
| Provider Name | Stella Ekaette Bassey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821070475 PECOS PAC ID: 8123000387 Enrollment ID: I20220323002919 |
| Provider Name | Chrysantus Nforbi Fusi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205580396 PECOS PAC ID: 1355737248 Enrollment ID: I20220331002826 |
| Provider Name | Mary Dymphina Gambrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740830942 PECOS PAC ID: 1850788993 Enrollment ID: I20220420001161 |
| Provider Name | Jason Leo Quesnelle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558029348 PECOS PAC ID: 6608263694 Enrollment ID: I20220421000489 |
| Provider Name | Marie Hasson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033152707 PECOS PAC ID: 5597776427 Enrollment ID: I20220517003127 |
| Provider Name | Courtney Judd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962881946 PECOS PAC ID: 3476930090 Enrollment ID: I20220519001061 |
| Provider Name | Matthew D Carpinello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790059194 PECOS PAC ID: 2466888904 Enrollment ID: I20220526000557 |
| Provider Name | Natalie W Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740563543 PECOS PAC ID: 7214195593 Enrollment ID: I20220608001667 |
| Provider Name | Robert Paul Blessin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801388657 PECOS PAC ID: 5395124234 Enrollment ID: I20220623000035 |
| Provider Name | Frederick Afton Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083119358 PECOS PAC ID: 3476807207 Enrollment ID: I20220623000889 |
| Provider Name | Carolyn Marie Gaulden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831689827 PECOS PAC ID: 4789063652 Enrollment ID: I20220623001123 |
| Provider Name | Kimbrelee Kaye Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730828625 PECOS PAC ID: 2961881552 Enrollment ID: I20220628003062 |
| Provider Name | Alvaro Jorge Gonzalez Alfonzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619405891 PECOS PAC ID: 0345589651 Enrollment ID: I20220629003666 |
| Provider Name | Heather Cochran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336870799 PECOS PAC ID: 0941680433 Enrollment ID: I20220629003750 |
| Provider Name | Andrew Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154826188 PECOS PAC ID: 8820478183 Enrollment ID: I20220704000131 |
| Provider Name | Sarah L Yankey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245726934 PECOS PAC ID: 5193105476 Enrollment ID: I20220705000048 |
| Provider Name | Kyle Galati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932698180 PECOS PAC ID: 3072859081 Enrollment ID: I20220706000852 |
| Provider Name | Osakhuemen W Ihenyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013437102 PECOS PAC ID: 4082009584 Enrollment ID: I20220713000079 |
| Provider Name | Daniel Stehli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861989345 PECOS PAC ID: 0042691677 Enrollment ID: I20220713004332 |
| Provider Name | Isabella Kanellopoulou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245354083 PECOS PAC ID: 4981782810 Enrollment ID: I20220722000915 |
| Provider Name | Hayley Ann Nunley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053068858 PECOS PAC ID: 0244613271 Enrollment ID: I20220823004168 |
| Provider Name | Marilyn Paradoa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053646067 PECOS PAC ID: 3678957875 Enrollment ID: I20220907003971 |
| Provider Name | Deola Saheed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972008381 PECOS PAC ID: 5799185989 Enrollment ID: I20220920002344 |
| Provider Name | Jeremiah Brewer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679968697 PECOS PAC ID: 8426366378 Enrollment ID: I20221013000764 |
| Provider Name | Bianca Strudwick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689056061 PECOS PAC ID: 0941676571 Enrollment ID: I20221021001568 |
| Provider Name | Monifa S Seawell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689834285 PECOS PAC ID: 7911154562 Enrollment ID: I20230110003277 |
| Provider Name | Deep Kalariya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306333513 PECOS PAC ID: 0042682809 Enrollment ID: I20230206000406 |
| Provider Name | Erin Marie Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932805959 PECOS PAC ID: 1850764770 Enrollment ID: I20230223002467 |
| Provider Name | Avrim Brett Fishkind |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093727943 PECOS PAC ID: 2466539804 Enrollment ID: I20230320001412 |
| Provider Name | Benita Cardell Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902313034 PECOS PAC ID: 7618341017 Enrollment ID: I20230327002100 |
| Provider Name | Johanna Torres-santiago |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659710721 PECOS PAC ID: 6204101744 Enrollment ID: I20230510002796 |
| Provider Name | Jenny Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952860249 PECOS PAC ID: 9133586738 Enrollment ID: I20230612003285 |
| Provider Name | Thomas A Rayner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194008979 PECOS PAC ID: 0941533574 Enrollment ID: I20230613000040 |
| Provider Name | Cameron Culver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922390558 PECOS PAC ID: 5698998748 Enrollment ID: I20230615000323 |
| Provider Name | Ryan M Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689133944 PECOS PAC ID: 3476912122 Enrollment ID: I20230629000171 |
| Provider Name | Kamron Fariba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407315864 PECOS PAC ID: 2567825979 Enrollment ID: I20230901001853 |
| Provider Name | Melissa Jane Sheldon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093414542 PECOS PAC ID: 2365816857 Enrollment ID: I20230901003283 |
| Provider Name | Uriah Millen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255023909 PECOS PAC ID: 1456715408 Enrollment ID: I20230911001349 |
| Provider Name | Edgar O Lopez De Castro Delgado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316500762 PECOS PAC ID: 6800284084 Enrollment ID: I20230913000390 |
| Provider Name | Benjamin Babchick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346700689 PECOS PAC ID: 8022440890 Enrollment ID: I20230918000570 |
| Provider Name | Alyssa Mae Bambard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023790201 PECOS PAC ID: 9234593526 Enrollment ID: I20230920000764 |
| Provider Name | Sahar Derakhshanian Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962065037 PECOS PAC ID: 7113257130 Enrollment ID: I20231023000896 |
| Provider Name | Tamara Anne Lazenby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508988494 PECOS PAC ID: 9032534037 Enrollment ID: I20231101000684 |
| Provider Name | Ksenia S Pillai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336657725 PECOS PAC ID: 0244575470 Enrollment ID: I20231201001942 |
| Provider Name | Laura J Cordonnier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992266993 PECOS PAC ID: 1658727482 Enrollment ID: I20231201002244 |
| Provider Name | Maanasa Bandla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063972404 PECOS PAC ID: 7618203035 Enrollment ID: I20231202000196 |
| Provider Name | Daniel Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528562865 PECOS PAC ID: 5890041420 Enrollment ID: I20231213001863 |
| Provider Name | Saurabh Kashyap |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275068702 PECOS PAC ID: 3678975141 Enrollment ID: I20240131000648 |
| Provider Name | Derrick Acheampong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063750081 PECOS PAC ID: 1951645423 Enrollment ID: I20240206002613 |
| Provider Name | Madeline Renals |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487217550 PECOS PAC ID: 4880924737 Enrollment ID: I20240206003280 |
| Provider Name | Clara Marina Ruiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881829596 PECOS PAC ID: 6507011178 Enrollment ID: I20240305001613 |
| Provider Name | Meredith R Cary-morrissette |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558493791 PECOS PAC ID: 1557644598 Enrollment ID: I20240318001325 |
| Provider Name | Hani Nazha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952501249 PECOS PAC ID: 0244486470 Enrollment ID: I20240318003305 |
| Provider Name | Andres Barkil-oteo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144467788 PECOS PAC ID: 9739338013 Enrollment ID: I20240325004010 |
| Provider Name | Mark Joseph Schlickman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972542157 PECOS PAC ID: 0941217715 Enrollment ID: I20240422002816 |
| Provider Name | Josue David Caban Alvarez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174076970 PECOS PAC ID: 1456790435 Enrollment ID: I20240424000630 |
Blessed Solutions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4302 Gulfwinds Dr, Lutz, FL 33558 Phone: 813-585-1953 | |
Structural Energetic Therapy Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 156b Whitaker Rd, Lutz, FL 33544 Phone: 813-949-2933 Fax: 813-944-2797 | |
Walgreens Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 25201 Wesley Chapel Blvd, Lutz, FL 33559 Phone: 813-453-6582 | |
Jj's Group Home& Wraparound Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 22452 Laureldale Dr, Lutz, FL 33549 Phone: 800-460-1416 Fax: 800-460-1416 | |
Julie J. Mckean, Lmhc, Ncc, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4929 Van Dyke Road, Lutz, FL 33558 Phone: 813-453-1151 Fax: 813-281-2474 | |
Sherley Valdez Arroyo Md Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16401 Penshurst Pl, Lutz, FL 33549 Phone: 787-505-2652 Fax: 888-347-9279 | |
Boundless Hope Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18703 N Dale Mabry Hwy, Lutz, FL 33548 Phone: 813-219-8844 |