| Cca Wellness Network Ipa Llc | |
|
196 Delaware Ave Delmar NY 12054-1230 | |
| (518) 439-0033 | |
| (518) 439-7167 |
| Full Name | Cca Wellness Network Ipa Llc |
|---|---|
| Speciality | Counselor |
| Location | 196 Delaware Ave, Delmar, New York |
| Authorized Official Name and Position | Allison Caprera (PRACTICE MANAGER, OWNER) |
| Authorized Official Contact | 8604553486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cca Wellness Network Ipa Llc 196 Delaware Ave Delmar NY 12054-1230 Ph: (518) 439-0033 | Cca Wellness Network Ipa Llc 196 Delaware Ave Delmar NY 12054-1230 Ph: (518) 439-0033 |
| NPI Number | 1992468813 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 10/18/2021 |
| Certification Date | 10/18/2021 |
| Medicare PECOS PAC ID | 2961893623 |
|---|---|
| Medicare Enrollment ID | O20220107000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992468813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Carol Colby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275525180 PECOS PAC ID: 0749354025 Enrollment ID: I20080805000181 |
| Provider Name | Perry Sherman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619960929 PECOS PAC ID: 2365635992 Enrollment ID: I20101014001495 |
| Provider Name | John Avallone Serra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659364982 PECOS PAC ID: 5193919991 Enrollment ID: I20101104001310 |
| Provider Name | Brian Louis Fast |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144212283 PECOS PAC ID: 0749234722 Enrollment ID: I20110302000359 |
| Provider Name | David A Myhre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326292863 PECOS PAC ID: 9830316272 Enrollment ID: I20140808001276 |
| Provider Name | James Richard Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457344798 PECOS PAC ID: 2365743903 Enrollment ID: I20151223001553 |
| Provider Name | Laura Elizabeth Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750788600 PECOS PAC ID: 7911396585 Enrollment ID: I20211119002293 |
Susan Gardiner, Psychiatrist,, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 785 Delaware Ave, Delmar, NY 12054 Phone: 518-439-1693 | |
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