|
| |
|
12011 Government Center Parkway Suite 836 Fairfax VA 22035 | |
| (703) 324-7000 | |
| (703) 653-6626 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 12011 Government Center Parkway, Fairfax, Virginia |
| Authorized Official Name and Position | Daryl Washington (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7033247000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
12011 Government Center Parkway Suite 836 Fairfax VA 22035 Ph: (703) 324-7000 | 12011 Government Center Parkway Suite 836 Fairfax VA 22035 Ph: (703) 324-7000 |
| NPI Number | 1154356244 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 10/01/2020 |
| Certification Date | 10/01/2020 |
| Medicare PECOS PAC ID | 9739136847 |
|---|---|
| Medicare Enrollment ID | O20210319001688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154356244 | NPI | - | NPPES |
| 222044 | Other | VA | ANTHEM |
| 010200229 | Medicaid | VA | |
| MHSS | Other | VA | AMERIGROUP |
| 004945107 | Medicaid | VA | |
| 010200270 | Medicaid | VA | |
| 5700 | Other | CAREFIRST BCBS NCA | |
| 008743126 | Medicaid | VA | |
| 010200181 | Medicaid | VA | |
| 541705851 | Other | TRICARE |
| Provider Name | Michael A Sherer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558378067 PECOS PAC ID: 7214820935 Enrollment ID: I20040205001218 |
| Provider Name | Philip S Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780608984 PECOS PAC ID: 4284520289 Enrollment ID: I20040226000163 |
| Provider Name | Amy M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447498951 PECOS PAC ID: 0547254385 Enrollment ID: I20040413001587 |
| Provider Name | Anil R Hinnaria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588687263 PECOS PAC ID: 3173514544 Enrollment ID: I20040524000564 |
| Provider Name | Cordelia Nieketien Tawari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194827139 PECOS PAC ID: 0648254359 Enrollment ID: I20040721001596 |
| Provider Name | Kumudini K Attanagoda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891801460 PECOS PAC ID: 8123098464 Enrollment ID: I20040726001375 |
| Provider Name | Donald E Bartlett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912062142 PECOS PAC ID: 0446219059 Enrollment ID: I20041008000613 |
| Provider Name | Ricardo Adrian Rius |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295751907 PECOS PAC ID: 1052203981 Enrollment ID: I20041204000168 |
| Provider Name | Brian H Marvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861410821 PECOS PAC ID: 0446216170 Enrollment ID: I20041206000008 |
| Provider Name | Debra W Obeirne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710045414 PECOS PAC ID: 4183674856 Enrollment ID: I20050131000381 |
| Provider Name | Simona Pick Both |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043246614 PECOS PAC ID: 7214982941 Enrollment ID: I20050316000121 |
| Provider Name | James T Thornburgh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043387236 PECOS PAC ID: 0244272201 Enrollment ID: I20050531000919 |
| Provider Name | Jivan S May |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245331107 PECOS PAC ID: 9537102710 Enrollment ID: I20050608000720 |
| Provider Name | Jyoti H Supanekar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902943483 PECOS PAC ID: 0244262251 Enrollment ID: I20050909000624 |
| Provider Name | Minh-chau Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851321491 PECOS PAC ID: 5496774390 Enrollment ID: I20051121000777 |
| Provider Name | Audrey M Rushin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689727349 PECOS PAC ID: 2062490675 Enrollment ID: I20051220000587 |
| Provider Name | Rochelle P Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528076668 PECOS PAC ID: 8628091824 Enrollment ID: I20060112000911 |
| Provider Name | Eileen N Bryceland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225052871 PECOS PAC ID: 2062410483 Enrollment ID: I20061120000319 |
| Provider Name | Arda Kasaci |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043395338 PECOS PAC ID: 7416958921 Enrollment ID: I20070126000122 |
| Provider Name | Robespierre M Del Rio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518980788 PECOS PAC ID: 1456352863 Enrollment ID: I20070129000298 |
| Provider Name | Judith Montville-white |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831292192 PECOS PAC ID: 9931201019 Enrollment ID: I20070220000349 |
| Provider Name | Marija Petrovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225138530 PECOS PAC ID: 9739281700 Enrollment ID: I20070221000488 |
| Provider Name | Huma Khalil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831175892 PECOS PAC ID: 5193788800 Enrollment ID: I20070501000140 |
| Provider Name | Laura M Sauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427134303 PECOS PAC ID: 5193811750 Enrollment ID: I20071012000602 |
| Provider Name | Joan Rockwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932269719 PECOS PAC ID: 9830275874 Enrollment ID: I20080401000174 |
| Provider Name | Nina R Sax-moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710175187 PECOS PAC ID: 3072690973 Enrollment ID: I20080402000532 |
| Provider Name | Rais A Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447432141 PECOS PAC ID: 1355410457 Enrollment ID: I20080515000218 |
| Provider Name | Yasir B Elamin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003945346 PECOS PAC ID: 6608945456 Enrollment ID: I20080520000096 |
| Provider Name | Zafar Rasheed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790982668 PECOS PAC ID: 0042389751 Enrollment ID: I20080521000520 |
| Provider Name | Anna G Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730353061 PECOS PAC ID: 4486722303 Enrollment ID: I20081006000311 |
| Provider Name | Nesly I Hneich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437313988 PECOS PAC ID: 8224197439 Enrollment ID: I20081103000554 |
| Provider Name | Conrad E Dennis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376728824 PECOS PAC ID: 7214092865 Enrollment ID: I20090213000209 |
| Provider Name | Maria Coica |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356470132 PECOS PAC ID: 8224129739 Enrollment ID: I20090220000420 |
| Provider Name | Gayle Nissen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982849782 PECOS PAC ID: 0244396646 Enrollment ID: I20090310000616 |
| Provider Name | Oanh D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821146663 PECOS PAC ID: 1254498124 Enrollment ID: I20090319000468 |
| Provider Name | Anjuli Jindal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043493372 PECOS PAC ID: 2668522111 Enrollment ID: I20090604000276 |
| Provider Name | Jacqueline L Tyler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871600635 PECOS PAC ID: 0840337572 Enrollment ID: I20091028000532 |
| Provider Name | Michael A Suppa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114937943 PECOS PAC ID: 1759423445 Enrollment ID: I20100119000224 |
| Provider Name | Sumera Nadeem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225226152 PECOS PAC ID: 6406922590 Enrollment ID: I20100202000255 |
| Provider Name | Katherine H Sikoryak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588722847 PECOS PAC ID: 0648303131 Enrollment ID: I20100804000781 |
| Provider Name | James A Steg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316050180 PECOS PAC ID: 1052436813 Enrollment ID: I20100916000719 |
| Provider Name | Erika A. Olander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396881082 PECOS PAC ID: 1153478383 Enrollment ID: I20100929000840 |
| Provider Name | Ayesha Mian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780851303 PECOS PAC ID: 5092902452 Enrollment ID: I20101210000359 |
| Provider Name | Amberly M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518112697 PECOS PAC ID: 5092901132 Enrollment ID: I20110104000384 |
| Provider Name | Allyson H Mosher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477571446 PECOS PAC ID: 5395934269 Enrollment ID: I20110107000057 |
| Provider Name | Robert A Macmurdo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083717144 PECOS PAC ID: 2466641063 Enrollment ID: I20110113000321 |
| Provider Name | Christopher D Barrows |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467569723 PECOS PAC ID: 6406037688 Enrollment ID: I20110221001007 |
| Provider Name | Ji-hae Park |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740339076 PECOS PAC ID: 0345427290 Enrollment ID: I20110602000384 |
| Provider Name | Corey S Thornton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639469166 PECOS PAC ID: 8527246727 Enrollment ID: I20110616000501 |
| Provider Name | Mary Salehi Boettler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780704197 PECOS PAC ID: 6204856172 Enrollment ID: I20110914000398 |
| Provider Name | John K Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679689897 PECOS PAC ID: 2860665072 Enrollment ID: I20111103000801 |
| Provider Name | Mai -chi T Ha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144316514 PECOS PAC ID: 7517131493 Enrollment ID: I20111111000362 |
| Provider Name | Robert E Ketcham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982611141 PECOS PAC ID: 5890969422 Enrollment ID: I20111117000256 |
| Provider Name | Kristen E Werner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154341675 PECOS PAC ID: 0648444760 Enrollment ID: I20111129000359 |
| Provider Name | Navneet Sidhu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194865428 PECOS PAC ID: 6103922091 Enrollment ID: I20120718000113 |
| Provider Name | Safaa M Kasem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023267606 PECOS PAC ID: 1153453014 Enrollment ID: I20120731000557 |
| Provider Name | Lara H Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669724456 PECOS PAC ID: 9931350733 Enrollment ID: I20121102000372 |
| Provider Name | C M Prasad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124131867 PECOS PAC ID: 5092950188 Enrollment ID: I20130320000231 |
| Provider Name | Todd M Augustus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912168238 PECOS PAC ID: 9436398054 Enrollment ID: I20130802000282 |
| Provider Name | Maria S Tsao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336257278 PECOS PAC ID: 1557595915 Enrollment ID: I20131018000339 |
| Provider Name | Sean C Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689681900 PECOS PAC ID: 8628290384 Enrollment ID: I20141112001987 |
| Provider Name | Daniel S Stanto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043452022 PECOS PAC ID: 1951523406 Enrollment ID: I20141118000304 |
| Provider Name | Sumerta Manchandani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649613902 PECOS PAC ID: 5890019533 Enrollment ID: I20150209000668 |
| Provider Name | Nicholas J Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912267196 PECOS PAC ID: 4981858248 Enrollment ID: I20150305000432 |
| Provider Name | Sarah E Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952704348 PECOS PAC ID: 7012235963 Enrollment ID: I20150406001390 |
| Provider Name | Lorency Fernando |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740332519 PECOS PAC ID: 9537182043 Enrollment ID: I20150407000420 |
| Provider Name | Steven J Shorman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114336054 PECOS PAC ID: 9436477247 Enrollment ID: I20150407001579 |
| Provider Name | Kathleen M Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154715910 PECOS PAC ID: 6608196357 Enrollment ID: I20150520000210 |
| Provider Name | Anola Tanga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336151331 PECOS PAC ID: 4789759978 Enrollment ID: I20150918001702 |
| Provider Name | Jason J Zodda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114210846 PECOS PAC ID: 4486962495 Enrollment ID: I20150924001463 |
| Provider Name | Michele Pia Meloni Barbosa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770699233 PECOS PAC ID: 6800104043 Enrollment ID: I20151007002443 |
| Provider Name | Angela S Amas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033592746 PECOS PAC ID: 5799094785 Enrollment ID: I20151013001971 |
| Provider Name | Mark V Sakran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922327196 PECOS PAC ID: 4688989460 Enrollment ID: I20151014002185 |
| Provider Name | Annie Le-hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992184758 PECOS PAC ID: 5799094165 Enrollment ID: I20151026001958 |
| Provider Name | Kathryn J Walseman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952628042 PECOS PAC ID: 4183933591 Enrollment ID: I20151027000624 |
| Provider Name | Sandra Garza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548651375 PECOS PAC ID: 0840519088 Enrollment ID: I20151215001200 |
| Provider Name | Olajumoke Ademola Adetunji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477989408 PECOS PAC ID: 1355643305 Enrollment ID: I20160125002777 |
| Provider Name | Sarah W Gebo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184083685 PECOS PAC ID: 7517263197 Enrollment ID: I20160308001037 |
| Provider Name | Orit Paytan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457725228 PECOS PAC ID: 7911205257 Enrollment ID: I20160419002721 |
| Provider Name | Nga N Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679818223 PECOS PAC ID: 4385933522 Enrollment ID: I20160511002194 |
| Provider Name | Lindsay A Moazzami |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043679319 PECOS PAC ID: 9931490992 Enrollment ID: I20160622000742 |
| Provider Name | Sahana Karpoor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568894947 PECOS PAC ID: 4183919434 Enrollment ID: I20160825000491 |
| Provider Name | Imran Akram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053449389 PECOS PAC ID: 9234237124 Enrollment ID: I20161025001256 |
| Provider Name | Tyrone N White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396295903 PECOS PAC ID: 2365726825 Enrollment ID: I20170228001618 |
| Provider Name | Aisha Sabir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609970631 PECOS PAC ID: 5193000446 Enrollment ID: I20170328002598 |
| Provider Name | Nora M Rowny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881068294 PECOS PAC ID: 6204112113 Enrollment ID: I20170407000354 |
| Provider Name | Emily T Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205372497 PECOS PAC ID: 1355627175 Enrollment ID: I20170411000174 |
| Provider Name | Shana M Grady |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356638274 PECOS PAC ID: 5698945491 Enrollment ID: I20170711002492 |
| Provider Name | Diana V Mata |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821354242 PECOS PAC ID: 4284907338 Enrollment ID: I20170912000960 |
| Provider Name | Samuel C Achu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518484443 PECOS PAC ID: 1254697048 Enrollment ID: I20171110001732 |
| Provider Name | Victor Maas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861919433 PECOS PAC ID: 8022374776 Enrollment ID: I20171113002118 |
| Provider Name | Rebecca Mello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528573243 PECOS PAC ID: 2860752425 Enrollment ID: I20180131000668 |
| Provider Name | Makoto Tanaka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073706727 PECOS PAC ID: 7719233527 Enrollment ID: I20180710001594 |
| Provider Name | Lisa A Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073010690 PECOS PAC ID: 0244589117 Enrollment ID: I20180827001200 |
| Provider Name | Afua B Addo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629598289 PECOS PAC ID: 4981954534 Enrollment ID: I20180904000419 |
| Provider Name | Mahum Hameed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295130078 PECOS PAC ID: 2466702782 Enrollment ID: I20180907001657 |
| Provider Name | Nikkimah P Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770611527 PECOS PAC ID: 7214287168 Enrollment ID: I20180913002601 |
| Provider Name | Hadley A Corcoran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245718386 PECOS PAC ID: 8628328598 Enrollment ID: I20180914000279 |
| Provider Name | Jennifer R Newhard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912177940 PECOS PAC ID: 3173874864 Enrollment ID: I20180919001276 |
| Provider Name | Jacqueline Washington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730199134 PECOS PAC ID: 9133471212 Enrollment ID: I20181018000723 |
| Provider Name | Kimberly Prosser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447738737 PECOS PAC ID: 5991058356 Enrollment ID: I20181101000397 |
| Provider Name | Cecilia Chrosny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396154175 PECOS PAC ID: 8820342983 Enrollment ID: I20181108002650 |
| Provider Name | Penelope A Konstas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275009953 PECOS PAC ID: 3476897620 Enrollment ID: I20181129001282 |
| Provider Name | Michelle J Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871061499 PECOS PAC ID: 9133463623 Enrollment ID: I20181211001228 |
| Provider Name | Gelila S Habte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639649148 PECOS PAC ID: 7517203623 Enrollment ID: I20190110002292 |
| Provider Name | Alfred Burnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497178420 PECOS PAC ID: 6103166475 Enrollment ID: I20190322002009 |
| Provider Name | Rachel W Girardi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740746783 PECOS PAC ID: 3971843939 Enrollment ID: I20190329000747 |
| Provider Name | Jennifer L Showalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508257437 PECOS PAC ID: 9133460975 Enrollment ID: I20190404001826 |
| Provider Name | Bradford Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487141537 PECOS PAC ID: 2264775212 Enrollment ID: I20190515002245 |
| Provider Name | Stephanie M Prior |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396204293 PECOS PAC ID: 7113260944 Enrollment ID: I20190520001219 |
| Provider Name | Johanna C Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689238891 PECOS PAC ID: 5294078028 Enrollment ID: I20190520001350 |
| Provider Name | Andrea R Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174080840 PECOS PAC ID: 8022345099 Enrollment ID: I20190814000430 |
| Provider Name | Ariel Silber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295380848 PECOS PAC ID: 3072843457 Enrollment ID: I20190927000821 |
| Provider Name | Caroline E Roberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659766624 PECOS PAC ID: 6305177213 Enrollment ID: I20191008000790 |
| Provider Name | Devon N Cavanaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134536469 PECOS PAC ID: 6800228743 Enrollment ID: I20191115000537 |
| Provider Name | Patricia R Herrity |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962045120 PECOS PAC ID: 2062844574 Enrollment ID: I20191120002915 |
| Provider Name | Kristen Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568913523 PECOS PAC ID: 0244510592 Enrollment ID: I20200121001070 |
| Provider Name | Bibiana G Ortiz Levine |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902441645 PECOS PAC ID: 7315374089 Enrollment ID: I20200219002210 |
| Provider Name | Abigail I Segall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487062659 PECOS PAC ID: 2163859471 Enrollment ID: I20200226002833 |
| Provider Name | Lacy J Jordan White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114408150 PECOS PAC ID: 7315289790 Enrollment ID: I20200423000390 |
| Provider Name | Irina Rasner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356959118 PECOS PAC ID: 3779908025 Enrollment ID: I20200803002335 |
| Provider Name | Jaclyn A Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942584917 PECOS PAC ID: 7416373741 Enrollment ID: I20200818001617 |
| Provider Name | Jean Y Cowan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730693433 PECOS PAC ID: 7517371107 Enrollment ID: I20210121002154 |
| Provider Name | Patricia Sloate |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962563643 PECOS PAC ID: 5193132512 Enrollment ID: I20210401000738 |
| Provider Name | Menetta Myers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518989342 PECOS PAC ID: 5991112195 Enrollment ID: I20210407000264 |
| Provider Name | David Edelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770698300 PECOS PAC ID: 1052729605 Enrollment ID: I20210420000738 |
| Provider Name | Dana Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669053302 PECOS PAC ID: 6103225982 Enrollment ID: I20210527001108 |
| Provider Name | Stacy J Mustico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811580343 PECOS PAC ID: 6103225891 Enrollment ID: I20210601000115 |
| Provider Name | Eunice Chai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811563844 PECOS PAC ID: 4587065081 Enrollment ID: I20210622000692 |
| Provider Name | Teresa Hollandsworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134701949 PECOS PAC ID: 7214338722 Enrollment ID: I20210622001052 |
| Provider Name | Erin Lauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467041244 PECOS PAC ID: 7416358932 Enrollment ID: I20210622001352 |
| Provider Name | Tiffany Barnhard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922407469 PECOS PAC ID: 4789087305 Enrollment ID: I20210720002918 |
| Provider Name | Jennifer Hugel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457958977 PECOS PAC ID: 1557764727 Enrollment ID: I20210726001752 |
| Provider Name | Claudia Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932783628 PECOS PAC ID: 4183027949 Enrollment ID: I20210730002259 |
| Provider Name | Suzyn Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437514338 PECOS PAC ID: 2961805726 Enrollment ID: I20210730002390 |
| Provider Name | Cynthia Awadzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164994000 PECOS PAC ID: 2264836709 Enrollment ID: I20210805003278 |
| Provider Name | Andreia Sabau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992478341 PECOS PAC ID: 7517362668 Enrollment ID: I20210831000058 |
| Provider Name | Ryan C Carey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891460648 PECOS PAC ID: 5890193445 Enrollment ID: I20211012001356 |
| Provider Name | Josephine Jita Dakin-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245814011 PECOS PAC ID: 7214326941 Enrollment ID: I20211117002844 |
| Provider Name | Azra Farooqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366621351 PECOS PAC ID: 6305237124 Enrollment ID: I20220104003036 |
| Provider Name | Olga V Zurita |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265191654 PECOS PAC ID: 8729471255 Enrollment ID: I20220207000203 |
| Provider Name | Andrew Lautar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407462286 PECOS PAC ID: 0941693303 Enrollment ID: I20220207001668 |
| Provider Name | Felicia Aboagye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003450412 PECOS PAC ID: 8628479128 Enrollment ID: I20220309001361 |
| Provider Name | David Klein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447998638 PECOS PAC ID: 9032599261 Enrollment ID: I20220706002590 |
| Provider Name | Sean C Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346897576 PECOS PAC ID: 5698150407 Enrollment ID: I20220915000178 |
| Provider Name | Simajah Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699408682 PECOS PAC ID: 1153798178 Enrollment ID: I20221104000623 |
| Provider Name | Natasha Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447981238 PECOS PAC ID: 3971970815 Enrollment ID: I20221104001483 |
| Provider Name | Joseph Fruth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730807041 PECOS PAC ID: 6709253313 Enrollment ID: I20221110000113 |
| Provider Name | Jingbo Seo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407582570 PECOS PAC ID: 0749659373 Enrollment ID: I20221202002760 |
| Provider Name | Kelsey Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588385447 PECOS PAC ID: 5496125478 Enrollment ID: I20230109001525 |
| Provider Name | Dezireh Jamshidarsani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689396376 PECOS PAC ID: 9234509225 Enrollment ID: I20230109001946 |
| Provider Name | Kameron Akhavain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083071914 PECOS PAC ID: 3072983071 Enrollment ID: I20230109002805 |
| Provider Name | Ahmun Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710609482 PECOS PAC ID: 3870963747 Enrollment ID: I20230111000135 |
| Provider Name | Paige Reitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780228775 PECOS PAC ID: 5092185827 Enrollment ID: I20230111003179 |
| Provider Name | Jade Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164146957 PECOS PAC ID: 1153791900 Enrollment ID: I20230112000900 |
| Provider Name | Shilah Francis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043945108 PECOS PAC ID: 0840661633 Enrollment ID: I20230112002945 |
| Provider Name | Shanese Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568179398 PECOS PAC ID: 4284005026 Enrollment ID: I20230113001882 |
| Provider Name | Robert Louchen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215646914 PECOS PAC ID: 9638540370 Enrollment ID: I20230117002334 |
| Provider Name | Meade Hanna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568187193 PECOS PAC ID: 1850762501 Enrollment ID: I20230117002728 |
| Provider Name | Tresha Eaglin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336890649 PECOS PAC ID: 1254703077 Enrollment ID: I20230203001993 |
| Provider Name | Holly Plotnick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952945297 PECOS PAC ID: 3971976945 Enrollment ID: I20230222003002 |
| Provider Name | Jocelyn Puller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912603556 PECOS PAC ID: 7416320312 Enrollment ID: I20230223001441 |
| Provider Name | Rebecca Ann Marksteiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902512346 PECOS PAC ID: 4486027638 Enrollment ID: I20230308002915 |
| Provider Name | Neerada Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770632606 PECOS PAC ID: 2062886278 Enrollment ID: I20230329001272 |
| Provider Name | Claire Josephine Campos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326763707 PECOS PAC ID: 9436524626 Enrollment ID: I20230330002005 |
| Provider Name | Judith Arlene Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578744371 PECOS PAC ID: 5496831547 Enrollment ID: I20230330002528 |
| Provider Name | Glenn Daniel Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649840505 PECOS PAC ID: 9931564515 Enrollment ID: I20230504000171 |
| Provider Name | Florence Hagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144538992 PECOS PAC ID: 7113168014 Enrollment ID: I20230515002087 |
| Provider Name | Kathleen Filak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902235765 PECOS PAC ID: 3476919184 Enrollment ID: I20230523002086 |
| Provider Name | Vostina Dinovo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639876071 PECOS PAC ID: 9032577192 Enrollment ID: I20230621003033 |
| Provider Name | Brandie O'hara Chaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588354088 PECOS PAC ID: 0244698314 Enrollment ID: I20230621003333 |
| Provider Name | Joanne Ocasio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427681626 PECOS PAC ID: 9830558139 Enrollment ID: I20230705001809 |
| Provider Name | Katie Arlene Rudzki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568184026 PECOS PAC ID: 7618336918 Enrollment ID: I20230705001960 |
| Provider Name | Mariela D Davila |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346937794 PECOS PAC ID: 6709246127 Enrollment ID: I20230718000466 |
| Provider Name | Lynn King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801350913 PECOS PAC ID: 7113388034 Enrollment ID: I20230725002474 |
| Provider Name | Anna Lee Koozmin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013694082 PECOS PAC ID: 5991166191 Enrollment ID: I20230804000116 |
| Provider Name | Amoya Rn Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376228841 PECOS PAC ID: 1557723368 Enrollment ID: I20230810002686 |
| Provider Name | Caitlin Summers-smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518433523 PECOS PAC ID: 2163806589 Enrollment ID: I20230905001066 |
| Provider Name | Kenna Belle Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205519055 PECOS PAC ID: 7214391960 Enrollment ID: I20230913002298 |
| Provider Name | Melanie Averion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538850474 PECOS PAC ID: 4688029879 Enrollment ID: I20231007000862 |
| Provider Name | Grace Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851826531 PECOS PAC ID: 8628424801 Enrollment ID: I20231024002444 |
| Provider Name | Claire Cassidy Capehart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538940168 PECOS PAC ID: 9830545797 Enrollment ID: I20231028000039 |
| Provider Name | Zach Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053002634 PECOS PAC ID: 5799131611 Enrollment ID: I20231031000525 |
| Provider Name | Kristen Lucas-stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962284968 PECOS PAC ID: 6002263506 Enrollment ID: I20231106000285 |
| Provider Name | Claire Merenda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679347710 PECOS PAC ID: 7911355979 Enrollment ID: I20231130003665 |
| Provider Name | Nhat Minh Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487275723 PECOS PAC ID: 7012365018 Enrollment ID: I20231201001319 |
| Provider Name | Stephanie Rebecca Ryan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508090036 PECOS PAC ID: 6103274014 Enrollment ID: I20231201002173 |
| Provider Name | Trisha Marie Hindy Burks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003550682 PECOS PAC ID: 4587013396 Enrollment ID: I20231205003065 |
| Provider Name | Catherine Hadeed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326813403 PECOS PAC ID: 7911356340 Enrollment ID: I20231211003756 |
| Provider Name | Bianca Quiles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235904772 PECOS PAC ID: 9032568399 Enrollment ID: I20231212001480 |
| Provider Name | Gaku Fujiyama |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780377580 PECOS PAC ID: 3274982293 Enrollment ID: I20231214003945 |
| Provider Name | Martia Alison Myers De Pina |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679954366 PECOS PAC ID: 2365891306 Enrollment ID: I20231215000748 |
| Provider Name | Rosemary Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386363356 PECOS PAC ID: 8224487129 Enrollment ID: I20231216000387 |
| Provider Name | Taylor Ashlee Boamah |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326600198 PECOS PAC ID: 9133578032 Enrollment ID: I20231216000392 |
| Provider Name | Kelly Ann Maio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730840364 PECOS PAC ID: 1456700368 Enrollment ID: I20231218000122 |
| Provider Name | Andrea Lynn Hess |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053495085 PECOS PAC ID: 0648629568 Enrollment ID: I20231218000507 |
| Provider Name | Shannon Grivas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225803695 PECOS PAC ID: 9436508389 Enrollment ID: I20231218001896 |
| Provider Name | Kathleen Ann Robertson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780692202 PECOS PAC ID: 3274982137 Enrollment ID: I20231218002518 |
| Provider Name | Heather Love Mcpherson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821552233 PECOS PAC ID: 2961851837 Enrollment ID: I20231218002719 |
| Provider Name | Lori Ann Kenepp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518160845 PECOS PAC ID: 4284083163 Enrollment ID: I20231218003377 |
| Provider Name | Leshara Bakare |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598531956 PECOS PAC ID: 0840649737 Enrollment ID: I20231218003699 |
| Provider Name | Richard Wylie Stephens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871182428 PECOS PAC ID: 7315397213 Enrollment ID: I20231219000143 |
| Provider Name | Devin Mckenzie Arnold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063958528 PECOS PAC ID: 2264882117 Enrollment ID: I20231219001982 |
| Provider Name | Colleen Ebel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528681160 PECOS PAC ID: 2961852744 Enrollment ID: I20231219003474 |
| Provider Name | Morela Hojohn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235622853 PECOS PAC ID: 6305296187 Enrollment ID: I20231219003578 |
| Provider Name | Edward Lee Curtis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962948174 PECOS PAC ID: 8820448624 Enrollment ID: I20231219004223 |
| Provider Name | Melanie Sarah Morgan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477276632 PECOS PAC ID: 9537519343 Enrollment ID: I20231220000459 |
| Provider Name | Brandon Hoffman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376154245 PECOS PAC ID: 3971953795 Enrollment ID: I20231220000910 |
| Provider Name | Jemeg Vann Dees |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679140222 PECOS PAC ID: 7214387034 Enrollment ID: I20231220000998 |
| Provider Name | Tameka D Tunsil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629271911 PECOS PAC ID: 3971953712 Enrollment ID: I20231220001801 |
| Provider Name | Yudy Emilce Wiley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861057853 PECOS PAC ID: 1557711306 Enrollment ID: I20231220002071 |
| Provider Name | Crystal Kominar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306009345 PECOS PAC ID: 1850741521 Enrollment ID: I20231220003241 |
| Provider Name | Ashley Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952835191 PECOS PAC ID: 4284084955 Enrollment ID: I20231220003374 |
| Provider Name | Jasmine Keyana Belvin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760057558 PECOS PAC ID: 1850741539 Enrollment ID: I20231220003698 |
| Provider Name | Cassie Jewell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124562251 PECOS PAC ID: 9638529324 Enrollment ID: I20231220003864 |
| Provider Name | Johnathan Redmond Stone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194165159 PECOS PAC ID: 9133579824 Enrollment ID: I20231220004080 |
| Provider Name | Nichelle Arnette Staten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972153831 PECOS PAC ID: 6103276803 Enrollment ID: I20231220004313 |
| Provider Name | Marsha Lane Webb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992734123 PECOS PAC ID: 4284084989 Enrollment ID: I20231221000039 |
| Provider Name | Seferino Martinez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447872783 PECOS PAC ID: 9638529332 Enrollment ID: I20231221000056 |
| Provider Name | Susan Beardsley Gatsos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790792653 PECOS PAC ID: 6901256601 Enrollment ID: I20231221000074 |
| Provider Name | Erin Kamber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437799202 PECOS PAC ID: 9830549575 Enrollment ID: I20231221001605 |
| Provider Name | Lishan Kassa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255534301 PECOS PAC ID: 4284084856 Enrollment ID: I20231221003483 |
| Provider Name | Karen Strobel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568522753 PECOS PAC ID: 2466802913 Enrollment ID: I20231222003016 |
| Provider Name | Jessica Rollings Coulson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508480880 PECOS PAC ID: 4486004926 Enrollment ID: I20231227000458 |
| Provider Name | Ericka Frizell Chandler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821439563 PECOS PAC ID: 0143670505 Enrollment ID: I20231227001476 |
| Provider Name | Kelsey Keane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487421004 PECOS PAC ID: 7719337120 Enrollment ID: I20231227003410 |
| Provider Name | Taleisha Ellerbe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255707931 PECOS PAC ID: 7911217211 Enrollment ID: I20231228000061 |
| Provider Name | Jonathan Oliver Wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134836810 PECOS PAC ID: 2163872581 Enrollment ID: I20231228000437 |
| Provider Name | Krystal Yeboah |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063130367 PECOS PAC ID: 8921458357 Enrollment ID: I20231228000649 |
| Provider Name | Marjolijn Narsis Hiemstra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659073161 PECOS PAC ID: 1456701887 Enrollment ID: I20231228000704 |
| Provider Name | Katrina Lynette Clay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841840170 PECOS PAC ID: 4981054210 Enrollment ID: I20231228000850 |
| Provider Name | Liciane Alves Mercado |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033829445 PECOS PAC ID: 7416307749 Enrollment ID: I20231228000908 |
| Provider Name | Kathleen Krupka Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417059502 PECOS PAC ID: 6406206739 Enrollment ID: I20231228000992 |
| Provider Name | Sarah Elizabeth Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568073476 PECOS PAC ID: 1759731003 Enrollment ID: I20231228001843 |
| Provider Name | Karla Campos-hunt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063196566 PECOS PAC ID: 0941650220 Enrollment ID: I20231228002580 |
| Provider Name | Amber Michelle Hines |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942475116 PECOS PAC ID: 9133579428 Enrollment ID: I20231228003053 |
| Provider Name | Aimee Michelle Francois |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578185823 PECOS PAC ID: 3274983572 Enrollment ID: I20231228003622 |
| Provider Name | David Rhee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568151074 PECOS PAC ID: 1355791542 Enrollment ID: I20240101000057 |
| Provider Name | Ruth Tedla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255701488 PECOS PAC ID: 0749630895 Enrollment ID: I20240102001690 |
| Provider Name | Misha Yasar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023723699 PECOS PAC ID: 3476904475 Enrollment ID: I20240103003840 |
| Provider Name | Elizabeth Ann Lisko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720504640 PECOS PAC ID: 4385095264 Enrollment ID: I20240104002080 |
| Provider Name | Maria Thomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386232056 PECOS PAC ID: 2567813462 Enrollment ID: I20240104002857 |
| Provider Name | Niah Richardson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881288413 PECOS PAC ID: 1658728381 Enrollment ID: I20240104003575 |
| Provider Name | Heather Bernhard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912314998 PECOS PAC ID: 8426409228 Enrollment ID: I20240105001717 |
| Provider Name | Christina Skyers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982191094 PECOS PAC ID: 0941651780 Enrollment ID: I20240105003047 |
| Provider Name | Melanie Cislo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588290118 PECOS PAC ID: 7416308176 Enrollment ID: I20240105004063 |
| Provider Name | Cristina Flora Russu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417052952 PECOS PAC ID: 6406207125 Enrollment ID: I20240108000518 |
| Provider Name | Regina Diana Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376892315 PECOS PAC ID: 8921459678 Enrollment ID: I20240108003805 |
| Provider Name | Amanda Leigh Davis-scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568977874 PECOS PAC ID: 2961853577 Enrollment ID: I20240109000224 |
| Provider Name | Molly A Jakubek |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295126118 PECOS PAC ID: 8820449333 Enrollment ID: I20240109004052 |
| Provider Name | Hyung Sook Kim |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518140748 PECOS PAC ID: 0143671669 Enrollment ID: I20240109004265 |
| Provider Name | Sana Ayub Lankford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265695050 PECOS PAC ID: 0648621177 Enrollment ID: I20240109004855 |
| Provider Name | Sarah Auld Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487202065 PECOS PAC ID: 2365893898 Enrollment ID: I20240109004892 |
| Provider Name | Ebony Fenwick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366166266 PECOS PAC ID: 8729439153 Enrollment ID: I20240110000339 |
| Provider Name | Daniel Robert Unger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669198958 PECOS PAC ID: 4981055324 Enrollment ID: I20240110000500 |
| Provider Name | Kim Vanessa Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780116483 PECOS PAC ID: 0941651384 Enrollment ID: I20240110000639 |
| Provider Name | Khadijah Shaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568235612 PECOS PAC ID: 8426409871 Enrollment ID: I20240110000922 |
| Provider Name | Liliana Labonte |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851702344 PECOS PAC ID: 0143671594 Enrollment ID: I20240110000960 |
| Provider Name | Lawrence Damon Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548276710 PECOS PAC ID: 7214388669 Enrollment ID: I20240110001030 |
| Provider Name | Stacy Fran Riley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235672445 PECOS PAC ID: 6002267465 Enrollment ID: I20240110001272 |
| Provider Name | Maurice Steven Martinez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801449988 PECOS PAC ID: 8921459330 Enrollment ID: I20240110003118 |
| Provider Name | Stacey Anne Lawson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124749098 PECOS PAC ID: 8729439054 Enrollment ID: I20240110004091 |
| Provider Name | Marisa Josefina Guijarro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790552602 PECOS PAC ID: 8426409756 Enrollment ID: I20240110004172 |
| Provider Name | Jisel Juliana Perilla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770293409 PECOS PAC ID: 7113378456 Enrollment ID: I20240110004719 |
| Provider Name | Margaret Suzanne Kirk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306907589 PECOS PAC ID: 0244681518 Enrollment ID: I20240111000450 |
| Provider Name | Jessica Lyn Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942788161 PECOS PAC ID: 1052762358 Enrollment ID: I20240111001362 |
| Provider Name | Eleanor H Barber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538391701 PECOS PAC ID: 8325499544 Enrollment ID: I20240111002532 |
| Provider Name | Carolina Celeste Balcazar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902155161 PECOS PAC ID: 2466803689 Enrollment ID: I20240111002770 |
| Provider Name | Latasha Blanding |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174948319 PECOS PAC ID: 5597065011 Enrollment ID: I20240111003480 |
| Provider Name | Chela T Rosales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710451505 PECOS PAC ID: 5496106650 Enrollment ID: I20240111003999 |
| Provider Name | Natalie Michelle Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144957051 PECOS PAC ID: 1254782410 Enrollment ID: I20240111004194 |
| Provider Name | Melanie Gott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699436378 PECOS PAC ID: 1658722822 Enrollment ID: I20240111004449 |
| Provider Name | Michael Dean Britt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841962693 PECOS PAC ID: 8628429891 Enrollment ID: I20240111004551 |
| Provider Name | Ryan Lynch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508419151 PECOS PAC ID: 4284085465 Enrollment ID: I20240111004905 |
| Provider Name | Kwame H Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902518962 PECOS PAC ID: 4880045988 Enrollment ID: I20240112000746 |
| Provider Name | Jasmine Felder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649907304 PECOS PAC ID: 4789036872 Enrollment ID: I20240112004063 |
| Provider Name | Desiree Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033524525 PECOS PAC ID: 9436501558 Enrollment ID: I20240113000772 |
| Provider Name | Kimberly Blefko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093440893 PECOS PAC ID: 7416309539 Enrollment ID: I20240113000821 |
| Provider Name | Liza Lobrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265779631 PECOS PAC ID: 7416326020 Enrollment ID: I20240114000103 |
| Provider Name | Troy Houston Criser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093339798 PECOS PAC ID: 4880046887 Enrollment ID: I20240116000398 |
| Provider Name | Monika Anna Beasley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659779098 PECOS PAC ID: 8729430749 Enrollment ID: I20240116000934 |
| Provider Name | Douglas Griffin Healey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528208006 PECOS PAC ID: 7113379140 Enrollment ID: I20240116001190 |
| Provider Name | Morgan Sebastian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538591144 PECOS PAC ID: 5698127660 Enrollment ID: I20240116002483 |
| Provider Name | Cynthia Ann Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255546347 PECOS PAC ID: 7719339688 Enrollment ID: I20240116002717 |
| Provider Name | Ana Milena Jacome |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275817538 PECOS PAC ID: 1254783137 Enrollment ID: I20240116003064 |
| Provider Name | Steven Michael Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891086195 PECOS PAC ID: 8729430624 Enrollment ID: I20240116003624 |
| Provider Name | Chelsea Riggs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750861670 PECOS PAC ID: 6406208305 Enrollment ID: I20240116003827 |
| Provider Name | Samuel Charles Wagner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437863222 PECOS PAC ID: 9234581141 Enrollment ID: I20240116004145 |
| Provider Name | Karen Mendez Gomez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215575170 PECOS PAC ID: 6305298233 Enrollment ID: I20240117000054 |
| Provider Name | Laura Kay Maddock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902078561 PECOS PAC ID: 0446602379 Enrollment ID: I20240117000178 |
| Provider Name | Leslie Healy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427616085 PECOS PAC ID: 5890147748 Enrollment ID: I20240117000937 |
| Provider Name | Alethea Collins-cavanaugh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720520067 PECOS PAC ID: 8224480041 Enrollment ID: I20240117003153 |
| Provider Name | Neva S Ortuno |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073841888 PECOS PAC ID: 6204288046 Enrollment ID: I20240117004005 |
| Provider Name | Bernadette Landry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184121667 PECOS PAC ID: 7315399078 Enrollment ID: I20240118000191 |
| Provider Name | Betty Mccurdy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427720507 PECOS PAC ID: 0749632404 Enrollment ID: I20240118000289 |
| Provider Name | Sharee T Haskins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922750140 PECOS PAC ID: 5496107161 Enrollment ID: I20240118000617 |
| Provider Name | Camilla Cryer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548737992 PECOS PAC ID: 6305298027 Enrollment ID: I20240118002114 |
| Provider Name | Mari-elaine Triolo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316579261 PECOS PAC ID: 5395197974 Enrollment ID: I20240118004282 |
| Provider Name | Shaun Louis Cruz Hampton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053189456 PECOS PAC ID: 4385096973 Enrollment ID: I20240118004676 |
| Provider Name | Rebecca Knowles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467066548 PECOS PAC ID: 9739531328 Enrollment ID: I20240118004695 |
| Provider Name | Donna S Ryan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346619376 PECOS PAC ID: 8426400961 Enrollment ID: I20240119001920 |
| Provider Name | Rodolfo Ernesto Marenco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407126808 PECOS PAC ID: 5698127173 Enrollment ID: I20240119003519 |
| Provider Name | Deborah Lynn Saba |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457982860 PECOS PAC ID: 0547612996 Enrollment ID: I20240122001351 |
| Provider Name | Mehrnush Mohebi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316267909 PECOS PAC ID: 4082066386 Enrollment ID: I20240123002306 |
| Provider Name | Charles M Ricker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861151235 PECOS PAC ID: 7719339951 Enrollment ID: I20240123003901 |
| Provider Name | Pouneh Zeraat |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376267427 PECOS PAC ID: 8921451154 Enrollment ID: I20240124002012 |
| Provider Name | Lakeisha Grayer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467077651 PECOS PAC ID: 9133572241 Enrollment ID: I20240125000366 |
| Provider Name | Maria C Mileo-silva |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982821104 PECOS PAC ID: 9830542950 Enrollment ID: I20240125000466 |
| Provider Name | Samar Yeganeh Helmstutler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609911668 PECOS PAC ID: 2668825712 Enrollment ID: I20240125001578 |
| Provider Name | Scott T Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437519550 PECOS PAC ID: 7810340882 Enrollment ID: I20240125002750 |
| Provider Name | Christine Krohl Heaton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467472340 PECOS PAC ID: 0648623637 Enrollment ID: I20240125003164 |
| Provider Name | Samira Joron-badr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306243373 PECOS PAC ID: 5991158800 Enrollment ID: I20240126003234 |
| Provider Name | Nichole R Honeycutt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871934919 PECOS PAC ID: 5193178028 Enrollment ID: I20240126004036 |
| Provider Name | Roxana Elizabeth Zepeda |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518366129 PECOS PAC ID: 3173976933 Enrollment ID: I20240129000109 |
| Provider Name | Karla Delgado |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740687409 PECOS PAC ID: 8325491996 Enrollment ID: I20240130003736 |
| Provider Name | Rebecca Kay Hogg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649743865 PECOS PAC ID: 3971956392 Enrollment ID: I20240201000430 |
| Provider Name | Gouss Joseph |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982321261 PECOS PAC ID: 6406209832 Enrollment ID: I20240201000811 |
| Provider Name | Shelby Rucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568235190 PECOS PAC ID: 6507219813 Enrollment ID: I20240201003908 |
| Provider Name | Kenisha Nicole Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376140970 PECOS PAC ID: 3779926092 Enrollment ID: I20240202003703 |
| Provider Name | Rhonda Kim Wiley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023488301 PECOS PAC ID: 7416390794 Enrollment ID: I20240205001021 |
| Provider Name | Anne Cornish Huertas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124031166 PECOS PAC ID: 1456794247 Enrollment ID: I20240208002591 |
| Provider Name | Ashley Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629793583 PECOS PAC ID: 6406299189 Enrollment ID: I20240209001281 |
| Provider Name | Erin Driggs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114258894 PECOS PAC ID: 4789027491 Enrollment ID: I20240209002003 |
| Provider Name | Bharati Patel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750394615 PECOS PAC ID: 2163865502 Enrollment ID: I20240213001598 |
| Provider Name | Kathryn Jean Powell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477785913 PECOS PAC ID: 3678917069 Enrollment ID: I20240213003653 |
| Provider Name | Gladys Santiago |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205554573 PECOS PAC ID: 4587008891 Enrollment ID: I20240214003380 |
| Provider Name | Adi G Moorman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083626733 PECOS PAC ID: 7618311705 Enrollment ID: I20240216001218 |
| Provider Name | Ashley Patricia Wise |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1063974392 PECOS PAC ID: 3476997446 Enrollment ID: I20240217000326 |
| Provider Name | Lauren Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912760125 PECOS PAC ID: 6709220700 Enrollment ID: I20240219000190 |
| Provider Name | Caroline Cook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508354291 PECOS PAC ID: 9931544426 Enrollment ID: I20240223001962 |
| Provider Name | Ronal Matthew Goff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942979778 PECOS PAC ID: 1850736968 Enrollment ID: I20240228003622 |
| Provider Name | Kristina Huggins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548796105 PECOS PAC ID: 6305282690 Enrollment ID: I20240308002084 |
| Provider Name | Dorothy Kerr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073044756 PECOS PAC ID: 4981040029 Enrollment ID: I20240311003352 |
| Provider Name | Bozena Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710521299 PECOS PAC ID: 9739541426 Enrollment ID: I20240313000452 |
| Provider Name | Winifred W Allen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598333676 PECOS PAC ID: 7810334869 Enrollment ID: I20240326001876 |
| Provider Name | Masako Longwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245012673 PECOS PAC ID: 4587001490 Enrollment ID: I20240327000122 |
| Provider Name | Jewel Francesca Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437333044 PECOS PAC ID: 3678910536 Enrollment ID: I20240327001713 |
| Provider Name | Michelle Elizabeth Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821516360 PECOS PAC ID: 1254778053 Enrollment ID: I20240327003698 |
| Provider Name | Samuel Wasserman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700642089 PECOS PAC ID: 1355788167 Enrollment ID: I20240327004162 |
| Provider Name | Julia Lynn Converse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013773985 PECOS PAC ID: 1052759727 Enrollment ID: I20240401003281 |
| Provider Name | Laura Bennecoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033975644 PECOS PAC ID: 2860830460 Enrollment ID: I20240402001449 |
| Provider Name | Jae Kim |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265155188 PECOS PAC ID: 7416395033 Enrollment ID: I20240402002285 |
| Provider Name | Jessica Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417553892 PECOS PAC ID: 5799123279 Enrollment ID: I20240403000501 |
| Provider Name | Justin Beverage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497505358 PECOS PAC ID: 4688012925 Enrollment ID: I20240404003073 |
| Provider Name | Lisa Eitches |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477173326 PECOS PAC ID: 9436597556 Enrollment ID: I20240409000344 |
| Provider Name | Krista Suzanne Rhodenhizer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598354359 PECOS PAC ID: 9436597598 Enrollment ID: I20240409001651 |
| Provider Name | Kelly Harper Larkin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659518470 PECOS PAC ID: 5991144875 Enrollment ID: I20240412000529 |
| Provider Name | Holly J Burley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104310762 PECOS PAC ID: 2163802547 Enrollment ID: I20240416002085 |
| Provider Name | Christopher Winters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194576991 PECOS PAC ID: 1254770894 Enrollment ID: I20240416002779 |
| Provider Name | Rosario Paredes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780043307 PECOS PAC ID: 7012358393 Enrollment ID: I20240517000920 |
| Provider Name | Kanisha Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558800326 PECOS PAC ID: 7911449863 Enrollment ID: I20240606001445 |
| Provider Name | Ernesto Antonio Torres-pena |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184465072 PECOS PAC ID: 9931644168 Enrollment ID: I20240712000406 |
| Provider Name | Xin Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023360427 PECOS PAC ID: 6002351806 Enrollment ID: I20240717001084 |
| Provider Name | Folasade Majestice Adebayo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386488435 PECOS PAC ID: 8628513330 Enrollment ID: I20240717001528 |
| Provider Name | Shirleen Shanta Rahman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437993243 PECOS PAC ID: 3870038599 Enrollment ID: I20240717001991 |
| Provider Name | Tameka Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427808716 PECOS PAC ID: 8123563871 Enrollment ID: I20240717002885 |
| Provider Name | Colleen C Starling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619316478 PECOS PAC ID: 1456897198 Enrollment ID: I20240718001743 |
| Provider Name | George David Annas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922267632 PECOS PAC ID: 6002118668 Enrollment ID: I20240718002710 |
| Provider Name | Kelsey Nicole Blackwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831664432 PECOS PAC ID: 4486190055 Enrollment ID: I20240719002137 |
| Provider Name | Lina Cuda |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013319458 PECOS PAC ID: 1052857935 Enrollment ID: I20240726003919 |
| Provider Name | Bryant Joyner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568209575 PECOS PAC ID: 5799221545 Enrollment ID: I20240729002292 |
| Provider Name | Claudia Christina Spain-grove |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679083133 PECOS PAC ID: 5991242489 Enrollment ID: I20240801002534 |
| Provider Name | Elizabeth Hendi Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073149399 PECOS PAC ID: 7113464652 Enrollment ID: I20240801004394 |
| Provider Name | Sara G Tariq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013007590 PECOS PAC ID: 6002951993 Enrollment ID: I20240807000251 |
| Provider Name | Randall Wayne Drury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720816390 PECOS PAC ID: 3375081409 Enrollment ID: I20240820001745 |
| Provider Name | Ashley Lynn Stright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811729072 PECOS PAC ID: 1456891431 Enrollment ID: I20240904004939 |
| Provider Name | Angela Terrell Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457504599 PECOS PAC ID: 2062578990 Enrollment ID: I20240909003759 |
| Provider Name | Jacklyne M Abdulai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699508648 PECOS PAC ID: 7214477850 Enrollment ID: I20240910000694 |
| Provider Name | Bree Ann F Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346995867 PECOS PAC ID: 8527508720 Enrollment ID: I20240913000927 |
| Provider Name | Regina Patente |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417781154 PECOS PAC ID: 1658811898 Enrollment ID: I20240913002444 |
| Provider Name | Joseph Aaron Burgus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972248078 PECOS PAC ID: 5991246829 Enrollment ID: I20240919000922 |
| Provider Name | Tiffany Monique Nicole Robinson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184932915 PECOS PAC ID: 8820539760 Enrollment ID: I20240919001231 |
| Provider Name | Alycia Serikstad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710712203 PECOS PAC ID: 2860933595 Enrollment ID: I20240923000764 |
| Provider Name | Max-andre Isidore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124854187 PECOS PAC ID: 4284166554 Enrollment ID: I20241011003389 |
| Provider Name | Samira Hafiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063230209 PECOS PAC ID: 2264964154 Enrollment ID: I20241016003939 |
| Provider Name | Jaqueline Oliveira Baroni |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417613795 PECOS PAC ID: 4789117078 Enrollment ID: I20241024003277 |
| Provider Name | Magaly J Gibson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558181511 PECOS PAC ID: 1254865553 Enrollment ID: I20241108002529 |
| Provider Name | Natalia Kanaev |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316769235 PECOS PAC ID: 4587199021 Enrollment ID: I20241121000729 |
| Provider Name | Alexandra Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831977529 PECOS PAC ID: 9032645791 Enrollment ID: I20241205001476 |
Integrative Psychotherapy Institute Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3615 Chain Bridge Rd Ste I, Fairfax, VA 22030 Phone: 703-385-9667 | |
Cognitive Consults And Technology Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 Hamaker Court, Suite 103, Neuropsychology Associates Of Fairfax, Fairfax, VA 22031 Phone: 703-876-0966 Fax: 703-876-1628 | |
U.s. Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4031 University Dr, Suite 100, Fairfax, VA 22030 Phone: 888-978-3801 Fax: 888-978-3802 | |
Dk. Elaine Williams, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3615 Chain Bridge Rd, Suite F, Fairfax, VA 22030 Phone: 703-383-1386 | |
Mzg Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4031 University Dr Ste 100, Fairfax, VA 22030 Phone: 703-375-9871 | |
Mindful Legacy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4229 Jefferson Oaks Cir Apt B, Fairfax, VA 22033 Phone: 703-718-6413 | |
A Center For Adult, Family And Career Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 10400 Eaton Pl, Suite 110, Fairfax, VA 22030 Phone: 703-346-3032 Fax: 703-691-0187 |