| Emily Program Pc | |
|
8001 Ravines Edge Ct Columbus OH 43235-5423 | |
| (866) 364-5977 | |
| (614) 896-8223 |
| Full Name | Emily Program Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8001 Ravines Edge Ct, Columbus, Ohio |
| Authorized Official Name and Position | Katherine Norris (GENERAL COUNSEL) |
| Authorized Official Contact | 8883645977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Program Pc 1295 Bandana Blvd N Ste 210 Saint Paul MN 55108-5115 Ph: (651) 645-5323 | Emily Program Pc 8001 Ravines Edge Ct Columbus OH 43235-5423 Ph: (866) 364-5977 |
| NPI Number | 1669444329 |
|---|---|
| Provider Enumeration Date | 02/06/2006 |
| Last Update Date | 01/31/2023 |
| Certification Date | 01/31/2023 |
| Medicare PECOS PAC ID | 8921068073 |
|---|---|
| Medicare Enrollment ID | O20041013001177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669444329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lydia Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902155286 PECOS PAC ID: 1658520432 Enrollment ID: I20121011000586 |
| Provider Name | Alison M Romanowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023353331 PECOS PAC ID: 0941454912 Enrollment ID: I20130129000568 |
| Provider Name | Whitney S Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386949428 PECOS PAC ID: 2961646526 Enrollment ID: I20130920000461 |
| Provider Name | Marjorie M Grafton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730510496 PECOS PAC ID: 1355668203 Enrollment ID: I20150402001310 |
| Provider Name | Mollie J Meisterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013377910 PECOS PAC ID: 8325330293 Enrollment ID: I20160713001900 |
| Provider Name | Caitlyn M Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184090953 PECOS PAC ID: 1355602624 Enrollment ID: I20180301000232 |
| Provider Name | Matthew D Brooker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679067631 PECOS PAC ID: 5496005431 Enrollment ID: I20180912001825 |
| Provider Name | Sarah Clementine Bergen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659724052 PECOS PAC ID: 5597004242 Enrollment ID: I20190416001171 |
| Provider Name | Troy A Becker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689235202 PECOS PAC ID: 7810225232 Enrollment ID: I20190823000077 |
| Provider Name | Adrianna Vanmeter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285295857 PECOS PAC ID: 6608105283 Enrollment ID: I20190906001474 |
| Provider Name | Caitlyn Starcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255834677 PECOS PAC ID: 6709212046 Enrollment ID: I20200205002399 |
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