| Bluestem Behavioral Health Group Llc | |
|
336 College Ave Ste 104 Beaver PA 15009-2231 | |
| (724) 774-1404 | |
| Not Available |
| Full Name | Bluestem Behavioral Health Group Llc |
|---|---|
| Speciality | Psychologist |
| Location | 336 College Ave Ste 104, Beaver, Pennsylvania |
| Authorized Official Name and Position | David Sprenkel (OWNER) |
| Authorized Official Contact | 7247741404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluestem Behavioral Health Group Llc 336 College Ave Ste 104 Beaver PA 15009-2231 Ph: (724) 774-1404 | Bluestem Behavioral Health Group Llc 336 College Ave Ste 104 Beaver PA 15009-2231 Ph: (724) 774-1404 |
| NPI Number | 1265532600 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 05/13/2008 |
| Medicare PECOS PAC ID | 5092702415 |
|---|---|
| Medicare Enrollment ID | O20040428000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265532600 | NPI | - | NPPES |
| 1454844 | Other | PA | PA BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
| Provider Name | David Gayle Sprenkel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629179320 PECOS PAC ID: 8022099266 Enrollment ID: I20040525001171 |
| Provider Name | Shannon C Lebak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003052754 PECOS PAC ID: 6406014539 Enrollment ID: I20120221000780 |
| Provider Name | Dante Dechellis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487125027 PECOS PAC ID: 3476906660 Enrollment ID: I20240124000936 |
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