| Lifestance Health | |
|
1055 E Baltimore Pike Ste 303 Media PA 19063-5173 | |
| (610) 892-3800 | |
| (484) 468-1412 |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1055 E Baltimore Pike Ste 303, Media, Pennsylvania |
| Authorized Official Name and Position | Ryan Pardo (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2063991493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health 1055 E Baltimore Pike Ste 303 Media PA 19063-5173 Ph: (610) 892-3800 | Lifestance Health 1055 E Baltimore Pike Ste 303 Media PA 19063-5173 Ph: (610) 892-3800 |
| NPI Number | 1952485864 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 2668436692 |
|---|---|
| Medicare Enrollment ID | O20041118000546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952485864 | NPI | - | NPPES |
| Provider Name | Randy A Inkles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962578021 PECOS PAC ID: 1557268364 Enrollment ID: I20031218000265 |
| Provider Name | Daniel C Marston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326009267 PECOS PAC ID: 0547158966 Enrollment ID: I20040308000998 |
| Provider Name | Jyotsna Vasudev |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932297587 PECOS PAC ID: 2365435880 Enrollment ID: I20040408000182 |
| Provider Name | A David Monheit |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306901038 PECOS PAC ID: 3173510989 Enrollment ID: I20040426000974 |
| Provider Name | Steven H Levy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497849426 PECOS PAC ID: 5092784991 Enrollment ID: I20040928000554 |
| Provider Name | Carol June Scanlon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093809030 PECOS PAC ID: 2264496215 Enrollment ID: I20041118000665 |
| Provider Name | Marla S Mcculloch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942239934 PECOS PAC ID: 2567476161 Enrollment ID: I20060213000150 |
| Provider Name | John M Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811939663 PECOS PAC ID: 2668483256 Enrollment ID: I20060510000469 |
| Provider Name | Steven D Malawski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184604548 PECOS PAC ID: 9335142645 Enrollment ID: I20060804000325 |
| Provider Name | Jutta Edith Vogt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629170840 PECOS PAC ID: 0840295317 Enrollment ID: I20060918000044 |
| Provider Name | Jilda S Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740473792 PECOS PAC ID: 7911077656 Enrollment ID: I20080606000071 |
| Provider Name | Marija G Cutlip |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326097650 PECOS PAC ID: 7315008968 Enrollment ID: I20081202000151 |
| Provider Name | Mindy B Rushbrook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043357817 PECOS PAC ID: 0244394716 Enrollment ID: I20090128000079 |
| Provider Name | Rommel Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619098159 PECOS PAC ID: 9335205939 Enrollment ID: I20090306000046 |
| Provider Name | Paree Stoulis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174617120 PECOS PAC ID: 5496805038 Enrollment ID: I20090602000633 |
| Provider Name | Beverly P White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952540221 PECOS PAC ID: 8527112366 Enrollment ID: I20090813000553 |
| Provider Name | Lauren P Napolitano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851574164 PECOS PAC ID: 0941355671 Enrollment ID: I20090902000313 |
| Provider Name | Lillian S Goertzel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134230733 PECOS PAC ID: 9931141579 Enrollment ID: I20091112000484 |
| Provider Name | Claudia S Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649503707 PECOS PAC ID: 2769527233 Enrollment ID: I20100309000025 |
| Provider Name | Mildred T Fajardo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023223351 PECOS PAC ID: 5395931794 Enrollment ID: I20101124000759 |
| Provider Name | Michael Pertschuk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609937903 PECOS PAC ID: 4880882539 Enrollment ID: I20101221001032 |
| Provider Name | Daria F Durny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407164031 PECOS PAC ID: 8123207214 Enrollment ID: I20110121000007 |
| Provider Name | Joanna P Frederick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336477504 PECOS PAC ID: 5294918421 Enrollment ID: I20110325000622 |
| Provider Name | Heather Callaghan-walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538253547 PECOS PAC ID: 8820271950 Enrollment ID: I20110325000749 |
| Provider Name | Deborah A Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285728212 PECOS PAC ID: 2961685037 Enrollment ID: I20110328000234 |
| Provider Name | Stacey Gill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447305271 PECOS PAC ID: 0244413235 Enrollment ID: I20110329000785 |
| Provider Name | Kyle B Holsinger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457445470 PECOS PAC ID: 9537218243 Enrollment ID: I20110401000561 |
| Provider Name | Marjory Levitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750361937 PECOS PAC ID: 2668658303 Enrollment ID: I20110523000121 |
| Provider Name | Charles J Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154438166 PECOS PAC ID: 2567649924 Enrollment ID: I20110613000034 |
| Provider Name | Alin J Severance |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033317938 PECOS PAC ID: 5991983058 Enrollment ID: I20110621000365 |
| Provider Name | Steven E. Simminger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568462232 PECOS PAC ID: 3274701297 Enrollment ID: I20110719000252 |
| Provider Name | Raghavendra Siragavarapu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154582377 PECOS PAC ID: 2062680705 Enrollment ID: I20110722000458 |
| Provider Name | Maxine P Kane |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023022704 PECOS PAC ID: 4688849557 Enrollment ID: I20111206000072 |
| Provider Name | Paul E Frye |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447202783 PECOS PAC ID: 7315112158 Enrollment ID: I20111207000052 |
| Provider Name | Jennifer A Shuss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821002577 PECOS PAC ID: 0143495994 Enrollment ID: I20111207000180 |
| Provider Name | Foster L. Hutchinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568480663 PECOS PAC ID: 0143496133 Enrollment ID: I20111221000475 |
| Provider Name | Susan C Gilman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619986148 PECOS PAC ID: 8820061963 Enrollment ID: I20120119000715 |
| Provider Name | Marian M Mullahy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992080444 PECOS PAC ID: 6002073152 Enrollment ID: I20120201000867 |
| Provider Name | Douglas C Achtert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710248091 PECOS PAC ID: 8325294457 Enrollment ID: I20120806000723 |
| Provider Name | Richard Thomas Weyler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083824387 PECOS PAC ID: 3577710920 Enrollment ID: I20120821000085 |
| Provider Name | Marjorie Rubin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316160013 PECOS PAC ID: 7810142759 Enrollment ID: I20130227000134 |
| Provider Name | Mahmoud A Elfatah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518129923 PECOS PAC ID: 0840445599 Enrollment ID: I20130301000258 |
| Provider Name | Saundra Hyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083911606 PECOS PAC ID: 5698910669 Enrollment ID: I20130321000393 |
| Provider Name | Mark Mcgrosky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477856599 PECOS PAC ID: 6406829159 Enrollment ID: I20130710000021 |
| Provider Name | Amy K Vaccaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164516118 PECOS PAC ID: 9133360431 Enrollment ID: I20130730000176 |
| Provider Name | Deepraj Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417258948 PECOS PAC ID: 9739315268 Enrollment ID: I20131111001550 |
| Provider Name | Lauren Cogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790027142 PECOS PAC ID: 0244469864 Enrollment ID: I20140131000282 |
| Provider Name | Gary Vallano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437255999 PECOS PAC ID: 9436380268 Enrollment ID: I20140320001087 |
| Provider Name | Teresa A Harrington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043481807 PECOS PAC ID: 2769708353 Enrollment ID: I20150225001302 |
| Provider Name | Marie E Kupis Bigas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841556883 PECOS PAC ID: 0941522106 Enrollment ID: I20150708001069 |
| Provider Name | Erica Borman |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1316258593 PECOS PAC ID: 1254646086 Enrollment ID: I20150821014393 |
| Provider Name | Joanne Mayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346265865 PECOS PAC ID: 8325348048 Enrollment ID: I20151202002598 |
| Provider Name | Sarah J Clayton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881862712 PECOS PAC ID: 0042514184 Enrollment ID: I20160210000123 |
| Provider Name | Treesa Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598159824 PECOS PAC ID: 9638476039 Enrollment ID: I20160330001724 |
| Provider Name | George Zappalorta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033556303 PECOS PAC ID: 6608169263 Enrollment ID: I20160720001484 |
| Provider Name | Alex Gross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578883179 PECOS PAC ID: 8325333024 Enrollment ID: I20160819000790 |
| Provider Name | Earl E Delong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477906881 PECOS PAC ID: 2860787868 Enrollment ID: I20160829002554 |
| Provider Name | David W Galbraith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710296801 PECOS PAC ID: 1557644879 Enrollment ID: I20170213000931 |
| Provider Name | Lezlee Betts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881937910 PECOS PAC ID: 5799060125 Enrollment ID: I20170327000090 |
| Provider Name | Catherine Mcnally |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073963054 PECOS PAC ID: 9133496169 Enrollment ID: I20170523002289 |
| Provider Name | Erika S Kawamura |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932341658 PECOS PAC ID: 5395013056 Enrollment ID: I20170621001513 |
| Provider Name | Beverly Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821264045 PECOS PAC ID: 7416228481 Enrollment ID: I20170809002753 |
| Provider Name | Carlene Lawson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730269283 PECOS PAC ID: 4486927753 Enrollment ID: I20170907003167 |
| Provider Name | Maddi Jane Sobel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932477353 PECOS PAC ID: 2961776877 Enrollment ID: I20170915001668 |
| Provider Name | Antony Harold Krumbhaar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285183095 PECOS PAC ID: 6305125048 Enrollment ID: I20171102001847 |
| Provider Name | Anna Juliette Esser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003336116 PECOS PAC ID: 6305106469 Enrollment ID: I20180209001107 |
| Provider Name | Laura Psy.d Russo-innamorato |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003900044 PECOS PAC ID: 2668655796 Enrollment ID: I20180226000747 |
| Provider Name | Sheri L Goldstrohm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881840841 PECOS PAC ID: 2668734245 Enrollment ID: I20180319002218 |
| Provider Name | Coleen A Lillie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861581134 PECOS PAC ID: 7517965775 Enrollment ID: I20180413000071 |
| Provider Name | Erica P Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811281793 PECOS PAC ID: 3779727508 Enrollment ID: I20180425000513 |
| Provider Name | Tiy L Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912210535 PECOS PAC ID: 6305192196 Enrollment ID: I20180710000511 |
| Provider Name | Seetha Chandrasekhara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134569486 PECOS PAC ID: 2264726405 Enrollment ID: I20180814003453 |
| Provider Name | Whitney Marie Robenolt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972082766 PECOS PAC ID: 8022368406 Enrollment ID: I20180905003041 |
| Provider Name | Leon E Cushenberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053669218 PECOS PAC ID: 1658660345 Enrollment ID: I20181012000941 |
| Provider Name | Samantha E Huyett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912484866 PECOS PAC ID: 4082966155 Enrollment ID: I20181018000501 |
| Provider Name | Elizabeth A Adwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396224895 PECOS PAC ID: 7719221670 Enrollment ID: I20181203003346 |
| Provider Name | Francine Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356824304 PECOS PAC ID: 9032453907 Enrollment ID: I20181204000473 |
| Provider Name | Anna M Byrne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679054324 PECOS PAC ID: 1052650215 Enrollment ID: I20190305003058 |
| Provider Name | Prianka Sinha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831502160 PECOS PAC ID: 1759627193 Enrollment ID: I20190313000296 |
| Provider Name | Kristen D Hamill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700174679 PECOS PAC ID: 1951641638 Enrollment ID: I20190315000321 |
| Provider Name | Kristin Mary Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104255116 PECOS PAC ID: 9830439298 Enrollment ID: I20190321000509 |
| Provider Name | Michelle E Schweitzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407314198 PECOS PAC ID: 0446592034 Enrollment ID: I20190501000904 |
| Provider Name | Melissa Renee Turkal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023526696 PECOS PAC ID: 1557694619 Enrollment ID: I20190605002319 |
| Provider Name | Laura Troxel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346892882 PECOS PAC ID: 7214265800 Enrollment ID: I20190820003754 |
| Provider Name | Daniel Auerbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396931077 PECOS PAC ID: 4587996327 Enrollment ID: I20191029001850 |
| Provider Name | David Edward Baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861682072 PECOS PAC ID: 2668806829 Enrollment ID: I20191220000776 |
| Provider Name | Mayra Nunez Zapata |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346770799 PECOS PAC ID: 8224463542 Enrollment ID: I20200115000344 |
| Provider Name | Roberto C Guerra |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003466384 PECOS PAC ID: 9739514977 Enrollment ID: I20200116002743 |
| Provider Name | Bryan Gastelle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801453477 PECOS PAC ID: 5496180143 Enrollment ID: I20200127001742 |
| Provider Name | Paul Alves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063074722 PECOS PAC ID: 1850727470 Enrollment ID: I20200130000875 |
| Provider Name | Yun Mi Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750938288 PECOS PAC ID: 9739515040 Enrollment ID: I20200205001314 |
| Provider Name | Elizabeth Wray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043842065 PECOS PAC ID: 4981030137 Enrollment ID: I20200206000150 |
| Provider Name | Gregory M Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780241661 PECOS PAC ID: 2062849821 Enrollment ID: I20200218000699 |
| Provider Name | Fitz Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972142669 PECOS PAC ID: 4486084167 Enrollment ID: I20200421000331 |
| Provider Name | Christine Joan Wolfe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417395559 PECOS PAC ID: 5698064442 Enrollment ID: I20200622000033 |
| Provider Name | Megan E Amatrudo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881135986 PECOS PAC ID: 4486078060 Enrollment ID: I20200716001436 |
| Provider Name | Michael Tolleson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740807775 PECOS PAC ID: 8325463995 Enrollment ID: I20200730001719 |
| Provider Name | Conor Macgregor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144776147 PECOS PAC ID: 6800211673 Enrollment ID: I20200811000877 |
| Provider Name | Taslim Zaman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275993628 PECOS PAC ID: 1850717158 Enrollment ID: I20200819003712 |
| Provider Name | Megahn S Albal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740815414 PECOS PAC ID: 4789003898 Enrollment ID: I20200827001706 |
| Provider Name | Latoya N Mohammed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558915967 PECOS PAC ID: 8820415029 Enrollment ID: I20200902002747 |
| Provider Name | Hawa A Mcghee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497991145 PECOS PAC ID: 5193143550 Enrollment ID: I20200916002167 |
| Provider Name | Scott R Ambrass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770048746 PECOS PAC ID: 8527488857 Enrollment ID: I20201026001684 |
| Provider Name | Wendy D Nickerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679170575 PECOS PAC ID: 3870903925 Enrollment ID: I20201102000909 |
| Provider Name | Helson J Meirino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104462787 PECOS PAC ID: 2365852746 Enrollment ID: I20201113002786 |
| Provider Name | Lisa Faul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821602087 PECOS PAC ID: 7810308665 Enrollment ID: I20201130000883 |
| Provider Name | Julianne Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770179343 PECOS PAC ID: 3173936549 Enrollment ID: I20201231000750 |
| Provider Name | Brittany N Daurizio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780284422 PECOS PAC ID: 0143633925 Enrollment ID: I20210115002052 |
| Provider Name | Nicole Kassandra Carissimi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770199341 PECOS PAC ID: 8123432903 Enrollment ID: I20210208001032 |
| Provider Name | Erin Ashley Colleran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134728330 PECOS PAC ID: 1254746589 Enrollment ID: I20210219000667 |
| Provider Name | Edward J Golden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245848555 PECOS PAC ID: 4486069549 Enrollment ID: I20210223001400 |
| Provider Name | Meera Khan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144823055 PECOS PAC ID: 0244646123 Enrollment ID: I20210302000885 |
| Provider Name | Brooke M Davidson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740833581 PECOS PAC ID: 3779990775 Enrollment ID: I20210318000113 |
| Provider Name | Kirah M Iovanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275118242 PECOS PAC ID: 9638586308 Enrollment ID: I20210324001712 |
| Provider Name | David Street |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902953797 PECOS PAC ID: 6204906191 Enrollment ID: I20210325000123 |
| Provider Name | Carolyn F Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851978183 PECOS PAC ID: 1759790975 Enrollment ID: I20210429000874 |
| Provider Name | Maureen K Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518542489 PECOS PAC ID: 5698184174 Enrollment ID: I20210513001297 |
| Provider Name | Amanda Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013507797 PECOS PAC ID: 0042629438 Enrollment ID: I20210517000010 |
| Provider Name | Ricardo Benitez Lemos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952869588 PECOS PAC ID: 3971920661 Enrollment ID: I20210607000071 |
| Provider Name | Sabra Ann Walter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043805567 PECOS PAC ID: 0749683878 Enrollment ID: I20210727000742 |
| Provider Name | Nicole Wilson-carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003990383 PECOS PAC ID: 9436150992 Enrollment ID: I20210927002464 |
| Provider Name | Raheela Sultan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245625318 PECOS PAC ID: 1355640483 Enrollment ID: I20211004000066 |
| Provider Name | Michael Ireland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740954700 PECOS PAC ID: 8527466358 Enrollment ID: I20211008002398 |
| Provider Name | Austin Robert Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023661386 PECOS PAC ID: 2163750282 Enrollment ID: I20211008002455 |
| Provider Name | Susan Mary Egan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720612807 PECOS PAC ID: 8527466259 Enrollment ID: I20211012000146 |
| Provider Name | Debra Herschberg Holder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265054720 PECOS PAC ID: 7113325846 Enrollment ID: I20211012000315 |
| Provider Name | Melissa M Stilwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609540715 PECOS PAC ID: 4587062179 Enrollment ID: I20211012003009 |
| Provider Name | Summer C Alonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023580644 PECOS PAC ID: 5496153959 Enrollment ID: I20211013003093 |
| Provider Name | Annah Wambul Murage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285206730 PECOS PAC ID: 0648678961 Enrollment ID: I20211018000156 |
| Provider Name | Kelsea E Chavis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629449335 PECOS PAC ID: 5294123808 Enrollment ID: I20211102000449 |
| Provider Name | Susan M. Mcilvain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427209212 PECOS PAC ID: 7911145842 Enrollment ID: I20211108000963 |
| Provider Name | Brianne Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639585847 PECOS PAC ID: 4183013980 Enrollment ID: I20211117001150 |
| Provider Name | Tiara K Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982176541 PECOS PAC ID: 1658618517 Enrollment ID: I20211123001954 |
| Provider Name | Denise Marie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225690225 PECOS PAC ID: 0547650863 Enrollment ID: I20211201000074 |
| Provider Name | Laurie L Weinberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104018431 PECOS PAC ID: 9537224704 Enrollment ID: I20211214002360 |
| Provider Name | Tiffany Helen Daye-lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831789908 PECOS PAC ID: 5092107532 Enrollment ID: I20220113001573 |
| Provider Name | Mary Jean Rainsford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629698774 PECOS PAC ID: 0648648709 Enrollment ID: I20221121001722 |
| Provider Name | Robin Ackerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699363440 PECOS PAC ID: 1850769795 Enrollment ID: I20221123002843 |
| Provider Name | Stephanie Karol Gibson-williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699496307 PECOS PAC ID: 3577932466 Enrollment ID: I20221215002896 |
| Provider Name | Julia Centrella |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720419120 PECOS PAC ID: 8729472683 Enrollment ID: I20230103002268 |
| Provider Name | Heather Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255905360 PECOS PAC ID: 3779953781 Enrollment ID: I20230109003008 |
| Provider Name | Jessica H Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659997971 PECOS PAC ID: 0042681785 Enrollment ID: I20230117002127 |
| Provider Name | Lisa Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073225751 PECOS PAC ID: 3870964034 Enrollment ID: I20230126000019 |
| Provider Name | Alaina Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801362819 PECOS PAC ID: 0244656817 Enrollment ID: I20230228000463 |
| Provider Name | Deborah Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639665292 PECOS PAC ID: 0042683161 Enrollment ID: I20230310000073 |
| Provider Name | Carole Tshela Showell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346853264 PECOS PAC ID: 2163881129 Enrollment ID: I20230708000398 |
| Provider Name | Jill M Rodger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568166817 PECOS PAC ID: 6507226099 Enrollment ID: I20230715000061 |
| Provider Name | Heather N Charboneau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538850144 PECOS PAC ID: 3274996376 Enrollment ID: I20230822002973 |
| Provider Name | Robert Stephen Kalas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295060721 PECOS PAC ID: 0749643880 Enrollment ID: I20230823000372 |
| Provider Name | Rachel Dillinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912402470 PECOS PAC ID: 7012258460 Enrollment ID: I20230830003460 |
| Provider Name | Erin Lindsay Bahmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780308502 PECOS PAC ID: 5092183368 Enrollment ID: I20230906002608 |
| Provider Name | Barbara Lynne Haines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336844497 PECOS PAC ID: 6800250606 Enrollment ID: I20230913000031 |
| Provider Name | Megan Ines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215499157 PECOS PAC ID: 5698139384 Enrollment ID: I20230913004211 |
| Provider Name | O'nisha Shanette Lawrence |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265667042 PECOS PAC ID: 3870957491 Enrollment ID: I20230915001194 |
| Provider Name | Kelly Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265989909 PECOS PAC ID: 4082941216 Enrollment ID: I20231004000962 |
| Provider Name | Renae Henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427469220 PECOS PAC ID: 9436504719 Enrollment ID: I20231005001968 |
| Provider Name | Shawn Newdeck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528397882 PECOS PAC ID: 8224483581 Enrollment ID: I20231006002028 |
| Provider Name | Ashley Barczok |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710405055 PECOS PAC ID: 4880952225 Enrollment ID: I20231007000204 |
| Provider Name | Ashley Marie Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144561598 PECOS PAC ID: 0648626325 Enrollment ID: I20231101001708 |
| Provider Name | Katherine Fedele |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902458623 PECOS PAC ID: 7214384668 Enrollment ID: I20231107003080 |
| Provider Name | Christine Arezzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942917075 PECOS PAC ID: 4385091271 Enrollment ID: I20231115000480 |
| Provider Name | Pranesh N Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730569294 PECOS PAC ID: 1658728431 Enrollment ID: I20231116000508 |
| Provider Name | Julie Ann Guido |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609265677 PECOS PAC ID: 8224485917 Enrollment ID: I20231117001616 |
| Provider Name | Courtney Cione |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093284101 PECOS PAC ID: 3971972969 Enrollment ID: I20231120003708 |
| Provider Name | Sarah Ann Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881467033 PECOS PAC ID: 0345698882 Enrollment ID: I20231122001513 |
| Provider Name | Alexander Patsiornik-fishkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326305194 PECOS PAC ID: 5698920114 Enrollment ID: I20231127000178 |
| Provider Name | Rita P Woidislawsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093463994 PECOS PAC ID: 2062860356 Enrollment ID: I20231127003460 |
| Provider Name | Christopher Rothwell Schwab |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740534817 PECOS PAC ID: 5890143689 Enrollment ID: I20231205001640 |
| Provider Name | Leona Frances Pierce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811687072 PECOS PAC ID: 8325498702 Enrollment ID: I20231227002279 |
| Provider Name | Cheryl Mccool |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265124499 PECOS PAC ID: 2365893393 Enrollment ID: I20240103004853 |
| Provider Name | Michelle Lynne Hajduk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649605106 PECOS PAC ID: 4385096262 Enrollment ID: I20240116003270 |
| Provider Name | Molly Robinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801357959 PECOS PAC ID: 4385096205 Enrollment ID: I20240116004424 |
| Provider Name | Kirsten L Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841920766 PECOS PAC ID: 6608228879 Enrollment ID: I20240124000156 |
| Provider Name | Amanda Louise Farrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750966727 PECOS PAC ID: 2567806201 Enrollment ID: I20240221001167 |
| Provider Name | Mary Rose Aldrich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134550155 PECOS PAC ID: 7416391909 Enrollment ID: I20240223001465 |
| Provider Name | Kathleen Anne Shannon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356435309 PECOS PAC ID: 6406291335 Enrollment ID: I20240229003795 |
| Provider Name | Mehrnaz Shoultes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154108959 PECOS PAC ID: 7810332772 Enrollment ID: I20240301000101 |
| Provider Name | Anthony Russo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720386626 PECOS PAC ID: 1759726672 Enrollment ID: I20240301002458 |
| Provider Name | Emily Caliguri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003696592 PECOS PAC ID: 8628413440 Enrollment ID: I20240301002611 |
| Provider Name | Nicole Cangelose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285395855 PECOS PAC ID: 2163867813 Enrollment ID: I20240304002613 |
| Provider Name | Sara C Cecchini |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992417885 PECOS PAC ID: 2961847579 Enrollment ID: I20240305000974 |
| Provider Name | Tori Capps |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053806190 PECOS PAC ID: 4880039411 Enrollment ID: I20240305001709 |
| Provider Name | Matthew Burkit |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629580105 PECOS PAC ID: 2961848569 Enrollment ID: I20240306000023 |
| Provider Name | Angela J Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790974921 PECOS PAC ID: 5698111235 Enrollment ID: I20240306001528 |
| Provider Name | Amelia Sermania |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083186159 PECOS PAC ID: 3173969250 Enrollment ID: I20240312000531 |
| Provider Name | Edward J Friel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073158333 PECOS PAC ID: 8527404649 Enrollment ID: I20240312002293 |
| Provider Name | Daniel J Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649850058 PECOS PAC ID: 4981040003 Enrollment ID: I20240312002315 |
| Provider Name | Kimberly Ann Gruber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689233595 PECOS PAC ID: 5799121737 Enrollment ID: I20240312003323 |
| Provider Name | Karlie Christine Greenhalgh-stricker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518676949 PECOS PAC ID: 1759727704 Enrollment ID: I20240312003885 |
| Provider Name | Jay Dickinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619095163 PECOS PAC ID: 9931545993 Enrollment ID: I20240312004256 |
| Provider Name | Jessica Hendrix |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609295732 PECOS PAC ID: 3577909548 Enrollment ID: I20240313000024 |
| Provider Name | Martine Lennon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083386288 PECOS PAC ID: 7517303514 Enrollment ID: I20240313001328 |
| Provider Name | Cara M. Dyson-o'connor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477977247 PECOS PAC ID: 3971949983 Enrollment ID: I20240313001370 |
| Provider Name | Maryn Penning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992869473 PECOS PAC ID: 6507202520 Enrollment ID: I20240313001813 |
| Provider Name | Nicole Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982301271 PECOS PAC ID: 7416393376 Enrollment ID: I20240313003735 |
| Provider Name | Kelly Catherine Pierce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841965928 PECOS PAC ID: 5698111557 Enrollment ID: I20240313003787 |
| Provider Name | Stacy K Rademacher Vance |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396457495 PECOS PAC ID: 6901242742 Enrollment ID: I20240314002562 |
| Provider Name | Dylan James Shearer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023744372 PECOS PAC ID: 5597101345 Enrollment ID: I20240314003171 |
| Provider Name | Ellen Ulmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750656088 PECOS PAC ID: 1254777048 Enrollment ID: I20240315000429 |
| Provider Name | Carissa Shobe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477108355 PECOS PAC ID: 8729424528 Enrollment ID: I20240315000706 |
| Provider Name | Jennifer Anne Swanson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669117685 PECOS PAC ID: 7719323435 Enrollment ID: I20240315001549 |
| Provider Name | Jennifer Velekei |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841845641 PECOS PAC ID: 5092113720 Enrollment ID: I20240315003644 |
| Provider Name | Sierra M Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578182663 PECOS PAC ID: 0840642427 Enrollment ID: I20240318000220 |
| Provider Name | Jonathan Mccomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023464997 PECOS PAC ID: 5991142309 Enrollment ID: I20240321000537 |
| Provider Name | Amber Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366078438 PECOS PAC ID: 9830536127 Enrollment ID: I20240321003895 |
| Provider Name | Angela Marie Mills |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447956214 PECOS PAC ID: 6002253390 Enrollment ID: I20240321003954 |
| Provider Name | Alicia Lauro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407573108 PECOS PAC ID: 8527405810 Enrollment ID: I20240321004032 |
| Provider Name | Chelsea M Snyder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568934156 PECOS PAC ID: 0941647242 Enrollment ID: I20240321004235 |
| Provider Name | Claire Myers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225724644 PECOS PAC ID: 1850738154 Enrollment ID: I20240321004236 |
| Provider Name | Amanda Jean Mullery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437806320 PECOS PAC ID: 5395182695 Enrollment ID: I20240322000032 |
| Provider Name | Irina Syrnikova |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689370975 PECOS PAC ID: 9133566433 Enrollment ID: I20240322000259 |
| Provider Name | Djola Zhana Mcgowan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194400200 PECOS PAC ID: 3072950385 Enrollment ID: I20240322000543 |
| Provider Name | Dumitrela Negru |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649866989 PECOS PAC ID: 4789099680 Enrollment ID: I20240322000718 |
| Provider Name | Jennifer Cunnane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013663871 PECOS PAC ID: 4284071507 Enrollment ID: I20240322000812 |
| Provider Name | Ashley Weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790367225 PECOS PAC ID: 6507203759 Enrollment ID: I20240322002788 |
| Provider Name | Abby Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710581855 PECOS PAC ID: 8022426733 Enrollment ID: I20240325000805 |
| Provider Name | Linda Santana |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366847204 PECOS PAC ID: 5294172144 Enrollment ID: I20240327001416 |
| Provider Name | Valeria Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619696861 PECOS PAC ID: 3375980238 Enrollment ID: I20240327001837 |
| Provider Name | Avis Pitkow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144643883 PECOS PAC ID: 6800233784 Enrollment ID: I20240327002832 |
| Provider Name | Sharon L Cuff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528265550 PECOS PAC ID: 8628416435 Enrollment ID: I20240328004043 |
| Provider Name | Jiao Shen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982172524 PECOS PAC ID: 1759729411 Enrollment ID: I20240401002983 |
| Provider Name | Katie Craig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659918720 PECOS PAC ID: 3678911187 Enrollment ID: I20240403001490 |
| Provider Name | Cristhian Dantagnan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033598578 PECOS PAC ID: 1052759560 Enrollment ID: I20240403001768 |
| Provider Name | Virginia M.w. Gardiner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265956668 PECOS PAC ID: 6608214077 Enrollment ID: I20240404000012 |
| Provider Name | Julie C Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821420787 PECOS PAC ID: 5597103937 Enrollment ID: I20240404002688 |
| Provider Name | Allison Basso |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710192638 PECOS PAC ID: 4880032010 Enrollment ID: I20240405002315 |
| Provider Name | Bradley J High |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588761688 PECOS PAC ID: 2567800618 Enrollment ID: I20240409001165 |
| Provider Name | Callan Weisser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114547692 PECOS PAC ID: 3375981426 Enrollment ID: I20240409001189 |
| Provider Name | Annie Jacob |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053066761 PECOS PAC ID: 6901244060 Enrollment ID: I20240409001613 |
| Provider Name | Lyndsey M Witmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922441922 PECOS PAC ID: 8022456193 Enrollment ID: I20240409001858 |
| Provider Name | Janet Lynn Roenne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306150651 PECOS PAC ID: 1658719737 Enrollment ID: I20240409002191 |
| Provider Name | Jeffrey Marshall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306479910 PECOS PAC ID: 9335587435 Enrollment ID: I20240409002742 |
| Provider Name | Natalie E Metzger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841673589 PECOS PAC ID: 0648618744 Enrollment ID: I20240409002958 |
| Provider Name | Jennifer Granozio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073276242 PECOS PAC ID: 7113365172 Enrollment ID: I20240410000104 |
| Provider Name | Sarah Burgess |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124895610 PECOS PAC ID: 2062850027 Enrollment ID: I20240410000268 |
| Provider Name | Virginia Lee Wolper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144990946 PECOS PAC ID: 9830537794 Enrollment ID: I20240410004166 |
| Provider Name | Toyye Shaquana Hargrove |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932974383 PECOS PAC ID: 0648618504 Enrollment ID: I20240410004198 |
| Provider Name | John Raymond Borella |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851632608 PECOS PAC ID: 5799124699 Enrollment ID: I20240411001726 |
| Provider Name | Glenn Tanner Shrum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164198800 PECOS PAC ID: 6709284730 Enrollment ID: I20240411001943 |
| Provider Name | Margaret Mary Albright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972608206 PECOS PAC ID: 8628417599 Enrollment ID: I20240412000083 |
| Provider Name | Daniel F Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053734970 PECOS PAC ID: 8921447723 Enrollment ID: I20240412001828 |
| Provider Name | Susan Dianne Mondaca |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790252542 PECOS PAC ID: 5092154815 Enrollment ID: I20240412002388 |
| Provider Name | Suzanne Marie Burkley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750408506 PECOS PAC ID: 0143669978 Enrollment ID: I20240412002957 |
| Provider Name | Celine Weinstein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487227922 PECOS PAC ID: 0840639696 Enrollment ID: I20240412003685 |
| Provider Name | Regina Niewodowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518017565 PECOS PAC ID: 9537508213 Enrollment ID: I20240415000312 |
| Provider Name | Amanda Lynn Alleman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962076513 PECOS PAC ID: 6709225469 Enrollment ID: I20240415003208 |
| Provider Name | Leah Ashley Cash |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619673621 PECOS PAC ID: 3870932478 Enrollment ID: I20240416001122 |
| Provider Name | Lisa Marie Ruggiano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558920512 PECOS PAC ID: 2567801178 Enrollment ID: I20240416001279 |
| Provider Name | Sandra Daisy Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447344494 PECOS PAC ID: 0143669754 Enrollment ID: I20240416001482 |
| Provider Name | Detra Shunell Flowers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639476005 PECOS PAC ID: 8921447541 Enrollment ID: I20240416001696 |
| Provider Name | Miriam Gabrielle Geier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700266616 PECOS PAC ID: 0446699847 Enrollment ID: I20240418001137 |
| Provider Name | Rebecca M Suralik |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699049031 PECOS PAC ID: 4981043098 Enrollment ID: I20240422001256 |
| Provider Name | Jaimee Arndt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952705477 PECOS PAC ID: 4082053103 Enrollment ID: I20240422001630 |
| Provider Name | Stephanie Denise Winfree |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659313740 PECOS PAC ID: 4385042027 Enrollment ID: I20240422001846 |
| Provider Name | Ray Hessek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356670228 PECOS PAC ID: 8022457167 Enrollment ID: I20240422002666 |
| Provider Name | Sarah A Kunkel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700443504 PECOS PAC ID: 3072952076 Enrollment ID: I20240423001790 |
| Provider Name | Elizabeth L Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750960472 PECOS PAC ID: 7113366147 Enrollment ID: I20240423003125 |
| Provider Name | Charles Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457076333 PECOS PAC ID: 8921448952 Enrollment ID: I20240424002700 |
| Provider Name | John Cosmo O'bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356621528 PECOS PAC ID: 2668812629 Enrollment ID: I20240424004026 |
| Provider Name | Alyson Greczyn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992291371 PECOS PAC ID: 4486094448 Enrollment ID: I20240424004035 |
| Provider Name | Julie Jeannine Klecker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124174024 PECOS PAC ID: 6608216585 Enrollment ID: I20240425000782 |
| Provider Name | Rae Ann Kotar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063039147 PECOS PAC ID: 3971943861 Enrollment ID: I20240425001141 |
| Provider Name | Carly S Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780396119 PECOS PAC ID: 4082054986 Enrollment ID: I20240425001431 |
| Provider Name | Jennifer Hammond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114432747 PECOS PAC ID: 1355781220 Enrollment ID: I20240426000207 |
| Provider Name | Alexia Renae Dalrymple |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093491599 PECOS PAC ID: 3870933658 Enrollment ID: I20240426000836 |
| Provider Name | Alyssa Caitlyn Lopez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437893237 PECOS PAC ID: 1557701976 Enrollment ID: I20240502002427 |
| Provider Name | Anna Morrow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205454667 PECOS PAC ID: 6204276553 Enrollment ID: I20240502004100 |
| Provider Name | Mina Mikhail |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598350662 PECOS PAC ID: 2567802820 Enrollment ID: I20240502004166 |
| Provider Name | Sarah Amon |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639800907 PECOS PAC ID: 9335580463 Enrollment ID: I20240507003394 |
| Provider Name | Alexandra Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790344588 PECOS PAC ID: 3779817226 Enrollment ID: I20240509002763 |
| Provider Name | Thomas W Yokoyama |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003106485 PECOS PAC ID: 1759722523 Enrollment ID: I20240510000475 |
| Provider Name | Stephanie Bromley Hoffner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902593684 PECOS PAC ID: 3274974050 Enrollment ID: I20240510000611 |
| Provider Name | Courtney Dominique Utz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366760217 PECOS PAC ID: 7517308091 Enrollment ID: I20240515001544 |
| Provider Name | Rashelle A Tomlinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437347549 PECOS PAC ID: 1254583297 Enrollment ID: I20240521003345 |
| Provider Name | Andrew Charney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386237295 PECOS PAC ID: 7416399209 Enrollment ID: I20240524001045 |
| Provider Name | Kaitlyn Marie Barnett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013629013 PECOS PAC ID: 8628410248 Enrollment ID: I20240529001145 |
| Provider Name | Nicholas A Vignati |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194573642 PECOS PAC ID: 7517309933 Enrollment ID: I20240530000875 |
| Provider Name | Maria Isabel Valentin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275129249 PECOS PAC ID: 6103268438 Enrollment ID: I20240531000980 |
| Provider Name | Travis Chase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508255068 PECOS PAC ID: 8921379124 Enrollment ID: I20240531001220 |
| Provider Name | Karen Shamus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013682038 PECOS PAC ID: 2466994645 Enrollment ID: I20240603003198 |
Syed M Rizvi Md Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 340 N Middletown Rd, Media, PA 19063 Phone: 610-891-5840 | |
Delaware County S.a.g.e. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 N Monroe St, Media, PA 19063 Phone: 484-432-0743 | |
Pasternak Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 Martins Run, Media, PA 19063 Phone: 610-353-7660 | |
Crozer Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 S Old Middletown Rd, Media, PA 19063 Phone: 610-619-9870 Fax: 610-619-9870 | |
Serenity Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 349 W Baltimore Ave, Street Level, Media, PA 19063 Phone: 610-329-2259 | |
Restoration Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 318 W Baltimore Ave Ste 3, Media, PA 19063 Phone: 610-585-0113 | |
Mess Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 W Front St, Media, PA 19063 Phone: 610-228-4800 |