| Brightside Medical, P.c. | |
|
1830 Colonial Village Ln Lancaster PA 17601-6700 | |
| (415) 360-3348 | |
| (855) 350-5708 |
| Full Name | Brightside Medical, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1830 Colonial Village Ln, Lancaster, Pennsylvania |
| Authorized Official Name and Position | Mirene Winsberg (ADMINISTRATION) |
| Authorized Official Contact | 4153603348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightside Medical, P.c. 156 2nd St San Francisco CA 94105-3724 Ph: (415) 360-3348 | Brightside Medical, P.c. 1830 Colonial Village Ln Lancaster PA 17601-6700 Ph: (415) 360-3348 |
| NPI Number | 1508325184 |
|---|---|
| Provider Enumeration Date | 03/13/2019 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 4082089461 |
|---|---|
| Medicare Enrollment ID | O20230418000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508325184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Candace Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467549212 PECOS PAC ID: 9234042060 Enrollment ID: I20031107000582 |
| Provider Name | Treesa Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598159824 PECOS PAC ID: 9638476039 Enrollment ID: I20160330001724 |
| Provider Name | Heather Madsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881149474 PECOS PAC ID: 5698057966 Enrollment ID: I20170120001962 |
| Provider Name | David J Halpern |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932633658 PECOS PAC ID: 8628346368 Enrollment ID: I20190830001507 |
| Provider Name | Brittany Kowalski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245825785 PECOS PAC ID: 7810305026 Enrollment ID: I20210427002221 |
| Provider Name | Nicole Wilson-carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003990383 PECOS PAC ID: 9436150992 Enrollment ID: I20210927002464 |
| Provider Name | Eunice Olayinka Itabiyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972939569 PECOS PAC ID: 9032508320 Enrollment ID: I20211108000292 |
| Provider Name | Lauren Linn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023780681 PECOS PAC ID: 9234527581 Enrollment ID: I20220621000881 |
| Provider Name | Rebecca Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275205973 PECOS PAC ID: 1658750484 Enrollment ID: I20220624000113 |
| Provider Name | Shannon Nicole Blanciak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801509450 PECOS PAC ID: 5890160279 Enrollment ID: I20230418000314 |
| Provider Name | Melissa Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457548075 PECOS PAC ID: 0143477885 Enrollment ID: I20230418002683 |
| Provider Name | Kristin Bartell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811366222 PECOS PAC ID: 7315300282 Enrollment ID: I20230824002359 |
| Provider Name | Ephraim Tokar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1538896857 PECOS PAC ID: 7517310741 Enrollment ID: I20240124002212 |
| Provider Name | Scott M Wushensky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235776337 PECOS PAC ID: 9830532027 Enrollment ID: I20240205002041 |
| Provider Name | Amy Marie Gray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841777513 PECOS PAC ID: 5496199945 Enrollment ID: I20240222004266 |
| Provider Name | Adam James Metz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144454083 PECOS PAC ID: 0143666354 Enrollment ID: I20240311002175 |
| Provider Name | Emani Wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275207201 PECOS PAC ID: 1557708138 Enrollment ID: I20240319000149 |
| Provider Name | Stephen Jeffrey Geibel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417965492 PECOS PAC ID: 1658339361 Enrollment ID: I20240327003518 |
| Provider Name | Janon Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790164622 PECOS PAC ID: 3072952860 Enrollment ID: I20240419000013 |
| Provider Name | Keri Ann Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487280665 PECOS PAC ID: 1254770316 Enrollment ID: I20240422003309 |
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