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16 Tri Park Way Appleton WI 54914-1658 | |
| (920) 841-8326 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16 Tri Park Way, Appleton, Wisconsin |
| Authorized Official Name and Position | Tasha Farrar (PRESIDENT) |
| Authorized Official Contact | 9208418326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
16 Tri Park Way Appleton WI 54914-1658 Ph: (920) 841-8326 | 16 Tri Park Way Appleton WI 54914-1658 Ph: (920) 841-8326 |
| NPI Number | 1649802281 |
|---|---|
| Provider Enumeration Date | 02/11/2020 |
| Last Update Date | 01/30/2025 |
| Certification Date | 01/30/2025 |
| Medicare PECOS PAC ID | 4981031309 |
|---|---|
| Medicare Enrollment ID | O20200225001810 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649802281 | NPI | - | NPPES |
| Provider Name | Linell K Berkley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649420134 PECOS PAC ID: 3476614405 Enrollment ID: I20081209000209 |
| Provider Name | Steven J Turchan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861406621 PECOS PAC ID: 5496729568 Enrollment ID: I20100306000221 |
| Provider Name | Tasha M Farrar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316977192 PECOS PAC ID: 4284637166 Enrollment ID: I20100902001119 |
| Provider Name | Melissa J Pecor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538488218 PECOS PAC ID: 8729274261 Enrollment ID: I20101123001208 |
| Provider Name | Joelle J Fellinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699077420 PECOS PAC ID: 8820279540 Enrollment ID: I20110228000828 |
| Provider Name | Sherrie L Kamm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912992298 PECOS PAC ID: 8527324409 Enrollment ID: I20201111001774 |
| Provider Name | Teri G Metropulos |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013407501 PECOS PAC ID: 3476906959 Enrollment ID: I20240131003884 |
| Provider Name | Danielle N Abraham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487023040 PECOS PAC ID: 8921547985 Enrollment ID: I20240822002237 |
| Provider Name | Kaitlyn A Gitter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235479320 PECOS PAC ID: 5597204370 Enrollment ID: I20240823003160 |
| Provider Name | Jennifer B Grube |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780866756 PECOS PAC ID: 7911446794 Enrollment ID: I20240823003315 |
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