| Family Institute, Pc | |
|
2100 S Columbia Rd Suite 202 Grand Forks ND 58201-5895 | |
| (701) 772-1588 | |
| (701) 746-6077 |
| Full Name | Family Institute, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2100 S Columbia Rd, Grand Forks, North Dakota |
| Authorized Official Name and Position | April Rain Bradley (PRESIDENT) |
| Authorized Official Contact | 7017721588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Institute, Pc 2100 S Columbia Rd Suite 202 Grand Forks ND 58201-5895 Ph: (701) 772-1588 | Family Institute, Pc 2100 S Columbia Rd Suite 202 Grand Forks ND 58201-5895 Ph: (701) 772-1588 |
| NPI Number | 1003832783 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 12/20/2011 |
| Medicare PECOS PAC ID | 8527054949 |
|---|---|
| Medicare Enrollment ID | O20040423000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003832783 | NPI | - | NPPES |
| 18321 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 184 (North Dakota) | Primary |
| Provider Name | Michael D Paulson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831109818 PECOS PAC ID: 4082600408 Enrollment ID: I20040421001799 |
| Provider Name | Carole Y Halone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144323700 PECOS PAC ID: 7719089457 Enrollment ID: I20070226000787 |
| Provider Name | David H Whitcomb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316140346 PECOS PAC ID: 6305937301 Enrollment ID: I20070806000478 |
| Provider Name | Jeanine E Kotschwar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083630974 PECOS PAC ID: 0143488064 Enrollment ID: I20120223000673 |
| Provider Name | Steven Meek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093005639 PECOS PAC ID: 6709013766 Enrollment ID: I20140708000857 |
| Provider Name | Joseph C Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447548904 PECOS PAC ID: 8820353733 Enrollment ID: I20180806000745 |
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