| Lifestance Health | |
|
250 Corporate Center Ct Stockbridge GA 30281 | |
| (770) 389-8100 | |
| (770) 389-3030 |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 250 Corporate Center Ct, Stockbridge, Georgia |
| Authorized Official Name and Position | Ryan Pardo (LEGAL CHIEF OFFICER) |
| 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 250 Corporate Center Ct Stockbridge GA 30281-6388 Ph: (770) 389-8100 | Lifestance Health 250 Corporate Center Ct Stockbridge GA 30281 Ph: (770) 389-8100 |
| NPI Number | 1881990869 |
|---|---|
| Provider Enumeration Date | 02/08/2011 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 5092611384 |
|---|---|
| Medicare Enrollment ID | O20120110000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881990869 | NPI | - | NPPES |
| Provider Name | Jayesh H Naik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356323877 PECOS PAC ID: 8224929880 Enrollment ID: I20040323000733 |
| Provider Name | Gregory W Melieste |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396794517 PECOS PAC ID: 0648254508 Enrollment ID: I20040617000215 |
| Provider Name | Asaf Aleem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851371405 PECOS PAC ID: 2365426269 Enrollment ID: I20040617000522 |
| Provider Name | Mark Vakkur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043224199 PECOS PAC ID: 5193702066 Enrollment ID: I20040630000161 |
| Provider Name | Arvind R Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033226220 PECOS PAC ID: 9234109273 Enrollment ID: I20040728000514 |
| Provider Name | Robert E Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679640106 PECOS PAC ID: 1658348917 Enrollment ID: I20040915000690 |
| Provider Name | Teresa P Lane |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1770638397 PECOS PAC ID: 8729035282 Enrollment ID: I20050408000367 |
| Provider Name | Piyush C Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184672008 PECOS PAC ID: 2466494687 Enrollment ID: I20050527000499 |
| Provider Name | Roy Q Sanders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528074101 PECOS PAC ID: 1850308198 Enrollment ID: I20060313000170 |
| Provider Name | Sasikanth Doddapaneni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114940095 PECOS PAC ID: 0345135885 Enrollment ID: I20060828000221 |
| Provider Name | Tammy J Denny-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780619049 PECOS PAC ID: 4688679459 Enrollment ID: I20060929000177 |
| Provider Name | Ramesh Babu Kannegenti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801895966 PECOS PAC ID: 7517967094 Enrollment ID: I20070213000199 |
| Provider Name | Ronald B Sites |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316059090 PECOS PAC ID: 8820191117 Enrollment ID: I20070306000677 |
| Provider Name | Ivan B Hoffman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861423360 PECOS PAC ID: 3476649831 Enrollment ID: I20071016000232 |
| Provider Name | Thomas Cobb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881702744 PECOS PAC ID: 3577532415 Enrollment ID: I20071101000078 |
| Provider Name | Jose M Artadi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811992787 PECOS PAC ID: 4183797384 Enrollment ID: I20080722000172 |
| Provider Name | Tommie M Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013006584 PECOS PAC ID: 2466510730 Enrollment ID: I20081015000685 |
| Provider Name | Seleem Sayyar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508044520 PECOS PAC ID: 8628136793 Enrollment ID: I20081017000270 |
| Provider Name | Betty Jo L Fancher |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093847840 PECOS PAC ID: 2668521899 Enrollment ID: I20090519000312 |
| Provider Name | Chiriyankandath S Sebastian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801907845 PECOS PAC ID: 3577613058 Enrollment ID: I20090603000398 |
| Provider Name | Donna L Londino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447369632 PECOS PAC ID: 6103976683 Enrollment ID: I20090603000406 |
| Provider Name | Stewart A Shevitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255442273 PECOS PAC ID: 6103976691 Enrollment ID: I20090603000508 |
| Provider Name | Edward C Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598704330 PECOS PAC ID: 0042362675 Enrollment ID: I20090713000530 |
| Provider Name | Revathi Koneru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023060266 PECOS PAC ID: 3779470513 Enrollment ID: I20090817000436 |
| Provider Name | Karisa Harpe |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1629304050 PECOS PAC ID: 2567501463 Enrollment ID: I20091207000412 |
| Provider Name | Louis A. Barton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467464438 PECOS PAC ID: 8022159987 Enrollment ID: I20100114000230 |
| Provider Name | Gaynell D Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366772253 PECOS PAC ID: 3870638364 Enrollment ID: I20100309000237 |
| Provider Name | Lindsey Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730345224 PECOS PAC ID: 9931234234 Enrollment ID: I20100311000677 |
| Provider Name | Kristin M Fiano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417015751 PECOS PAC ID: 2769517325 Enrollment ID: I20100322000233 |
| Provider Name | Bandupriya P Vidanagama |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164523254 PECOS PAC ID: 9739215922 Enrollment ID: I20100326000499 |
| Provider Name | Kevin J Winders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275577520 PECOS PAC ID: 3173539954 Enrollment ID: I20100604000004 |
| Provider Name | Andrea M Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164753034 PECOS PAC ID: 7012041213 Enrollment ID: I20100810000350 |
| Provider Name | Roma S Raheja |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093032476 PECOS PAC ID: 3274667365 Enrollment ID: I20100811000251 |
| Provider Name | Lisa M Sheehan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518146059 PECOS PAC ID: 0547385221 Enrollment ID: I20100917000955 |
| Provider Name | Barry N Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518029586 PECOS PAC ID: 9537176565 Enrollment ID: I20101104000752 |
| Provider Name | Karen V Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134237209 PECOS PAC ID: 3173710894 Enrollment ID: I20101207001229 |
| Provider Name | Hemachandra P Gunawardhana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558369413 PECOS PAC ID: 6002851672 Enrollment ID: I20110124000875 |
| Provider Name | Daniel A Bochner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104987320 PECOS PAC ID: 2163601527 Enrollment ID: I20110201000374 |
| Provider Name | Michelle Marie Morris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922197862 PECOS PAC ID: 7214940758 Enrollment ID: I20110217000073 |
| Provider Name | Stephen A Felker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528142775 PECOS PAC ID: 2860405305 Enrollment ID: I20110301000630 |
| Provider Name | David P Law |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770690604 PECOS PAC ID: 5991977175 Enrollment ID: I20111012000303 |
| Provider Name | Jacquelyn D. Owens |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1184845513 PECOS PAC ID: 9133393846 Enrollment ID: I20111115000465 |
| Provider Name | Margaret O Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265582357 PECOS PAC ID: 4284809179 Enrollment ID: I20111205000206 |
| Provider Name | Joyce Webb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073696951 PECOS PAC ID: 0840396016 Enrollment ID: I20111207000383 |
| Provider Name | David Hermecz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699849265 PECOS PAC ID: 0345415089 Enrollment ID: I20111208000547 |
| Provider Name | Cecile Pasion-bregman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396832002 PECOS PAC ID: 0244406460 Enrollment ID: I20120110000122 |
| Provider Name | Shashank K Jha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174800072 PECOS PAC ID: 7719153360 Enrollment ID: I20120131000672 |
| Provider Name | Crystal Lewis Nelson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437356870 PECOS PAC ID: 5496915209 Enrollment ID: I20120330000607 |
| Provider Name | Nia Michelle Sipp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609905959 PECOS PAC ID: 9133381676 Enrollment ID: I20120501000215 |
| Provider Name | Daniel B Nagelberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396805131 PECOS PAC ID: 9335219427 Enrollment ID: I20120606000493 |
| Provider Name | Karl S Mihalovits |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588767909 PECOS PAC ID: 0143476499 Enrollment ID: I20120802000248 |
| Provider Name | David L Klein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790962942 PECOS PAC ID: 0244486074 Enrollment ID: I20120810000418 |
| Provider Name | Nirupama A Natarajan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942411251 PECOS PAC ID: 4486800083 Enrollment ID: I20120815000176 |
| Provider Name | Lok Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366641458 PECOS PAC ID: 3870740871 Enrollment ID: I20120827000651 |
| Provider Name | Helen B Renfroe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346479771 PECOS PAC ID: 2961659685 Enrollment ID: I20120830000483 |
| Provider Name | Athena H Sotus-nawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902070162 PECOS PAC ID: 9739337817 Enrollment ID: I20120914000101 |
| Provider Name | Shakaola Pinero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427310564 PECOS PAC ID: 0648429134 Enrollment ID: I20120926000731 |
| Provider Name | Syed A Imam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144413733 PECOS PAC ID: 7618147521 Enrollment ID: I20121011000218 |
| Provider Name | Christie Salamone Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972880185 PECOS PAC ID: 0244480192 Enrollment ID: I20121030000473 |
| Provider Name | David Walker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043560998 PECOS PAC ID: 5092966101 Enrollment ID: I20121120000466 |
| Provider Name | Priyanka Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902098197 PECOS PAC ID: 8426201039 Enrollment ID: I20130110000247 |
| Provider Name | Tammy L Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467790915 PECOS PAC ID: 4789829862 Enrollment ID: I20130320000159 |
| Provider Name | Melanie Johnson Pointer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275736902 PECOS PAC ID: 8729225289 Enrollment ID: I20130501000222 |
| Provider Name | Janet L Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205179710 PECOS PAC ID: 9335388263 Enrollment ID: I20130625000399 |
| Provider Name | Michelle C Cenerizio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629410204 PECOS PAC ID: 0840433041 Enrollment ID: I20130906000268 |
| Provider Name | Srinivas Kolipaka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831381433 PECOS PAC ID: 0941326789 Enrollment ID: I20140114001232 |
| Provider Name | Darlene Mcnulty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235215211 PECOS PAC ID: 7810998317 Enrollment ID: I20140408000876 |
| Provider Name | Joanna Y Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558560649 PECOS PAC ID: 6901040914 Enrollment ID: I20140421002027 |
| Provider Name | Stephen A Fleming |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265639835 PECOS PAC ID: 1759515950 Enrollment ID: I20140502001746 |
| Provider Name | Christopher M Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821140237 PECOS PAC ID: 5193890143 Enrollment ID: I20140808001252 |
| Provider Name | Erika C Kang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639568066 PECOS PAC ID: 2163740911 Enrollment ID: I20150408000610 |
| Provider Name | Tierra S Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871986331 PECOS PAC ID: 9537488218 Enrollment ID: I20150430001086 |
| Provider Name | Elizabeth M Licalzi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629210471 PECOS PAC ID: 4385885250 Enrollment ID: I20150527001611 |
| Provider Name | Tracy Das |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114243375 PECOS PAC ID: 4688985153 Enrollment ID: I20150624002602 |
| Provider Name | Rashelle A Tomlinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437347549 PECOS PAC ID: 1254583297 Enrollment ID: I20150718000039 |
| Provider Name | Naureen Munawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245420082 PECOS PAC ID: 9931363413 Enrollment ID: I20150721002943 |
| Provider Name | Victoria J Epp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942403142 PECOS PAC ID: 8527374198 Enrollment ID: I20150826002724 |
| Provider Name | Mackenzie M Natta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457733891 PECOS PAC ID: 2567772437 Enrollment ID: I20151104002190 |
| Provider Name | Windy D Meadows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407222953 PECOS PAC ID: 2961712757 Enrollment ID: I20151106001091 |
| Provider Name | Nancy M Eschette |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316031370 PECOS PAC ID: 2062701089 Enrollment ID: I20160516000442 |
| Provider Name | Charles Guillaume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114322419 PECOS PAC ID: 4981996378 Enrollment ID: I20160705001421 |
| Provider Name | Lisha Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073853826 PECOS PAC ID: 3870885999 Enrollment ID: I20160711002102 |
| Provider Name | Caroline B Derosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841685831 PECOS PAC ID: 1759674013 Enrollment ID: I20160725000397 |
| Provider Name | Olawunmi Ogun-semore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104287283 PECOS PAC ID: 6002101946 Enrollment ID: I20160817000921 |
| Provider Name | Marie-andree Parent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639539125 PECOS PAC ID: 7315235512 Enrollment ID: I20161004000250 |
| Provider Name | Samantha Patrice Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649646431 PECOS PAC ID: 6800174020 Enrollment ID: I20161024000142 |
| Provider Name | Constance Meinken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497202402 PECOS PAC ID: 7315225075 Enrollment ID: I20161031002320 |
| Provider Name | Neil Bhupendra Jariwala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710206545 PECOS PAC ID: 0941425607 Enrollment ID: I20170126001656 |
| Provider Name | Jacqueline L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477092856 PECOS PAC ID: 8426327594 Enrollment ID: I20170705001328 |
| Provider Name | Gary Matthews |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689018772 PECOS PAC ID: 2961771951 Enrollment ID: I20170707000135 |
| Provider Name | Akinlawon Ayeni |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1821167149 PECOS PAC ID: 4981782331 Enrollment ID: I20170915000082 |
| Provider Name | Jean F Cadet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417485491 PECOS PAC ID: 0547536724 Enrollment ID: I20171017001587 |
| Provider Name | Tina Ezeolisah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306299268 PECOS PAC ID: 1850667957 Enrollment ID: I20171017002720 |
| Provider Name | Ashaki Warren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437416286 PECOS PAC ID: 3678712544 Enrollment ID: I20171025003559 |
| Provider Name | Jagruti Chaudhari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992245591 PECOS PAC ID: 9931475357 Enrollment ID: I20171030001361 |
| Provider Name | Akemi-joi Mcgoogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174935332 PECOS PAC ID: 7315207750 Enrollment ID: I20180205000849 |
| Provider Name | William T Dwight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316462211 PECOS PAC ID: 7719241611 Enrollment ID: I20180430002833 |
| Provider Name | Raja V Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114946746 PECOS PAC ID: 5092628230 Enrollment ID: I20180505000097 |
| Provider Name | Jean Goldthwait |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679904437 PECOS PAC ID: 9537423900 Enrollment ID: I20180511000080 |
| Provider Name | Yarvarious Tarvett Standley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477077360 PECOS PAC ID: 8426313578 Enrollment ID: I20180521002182 |
| Provider Name | Jami Hanneman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093213514 PECOS PAC ID: 0446515993 Enrollment ID: I20180604001107 |
| Provider Name | Martha Lillian Murry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427113216 PECOS PAC ID: 6103921689 Enrollment ID: I20180606001459 |
| Provider Name | Esther Narhmartey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033632047 PECOS PAC ID: 1254686652 Enrollment ID: I20180625003589 |
| Provider Name | Whitney T. Krawczyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477060390 PECOS PAC ID: 4587911987 Enrollment ID: I20180717000809 |
| Provider Name | Candace Giles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528321098 PECOS PAC ID: 2860779477 Enrollment ID: I20180724001128 |
| Provider Name | Candace Giles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528321098 PECOS PAC ID: 2860779477 Enrollment ID: I20180724001303 |
| Provider Name | Larrice T Gorley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417458498 PECOS PAC ID: 4082962683 Enrollment ID: I20180730001000 |
| Provider Name | Jennifer Lynn Davenport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700394319 PECOS PAC ID: 0446224083 Enrollment ID: I20180730003411 |
| Provider Name | Timothy Curran |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063910305 PECOS PAC ID: 9931458551 Enrollment ID: I20180815001378 |
| Provider Name | Hawah Comfort Guar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194220608 PECOS PAC ID: 8628327145 Enrollment ID: I20180816002167 |
| Provider Name | Pamela C Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548591605 PECOS PAC ID: 8628332939 Enrollment ID: I20180821003968 |
| Provider Name | Brooke Boccaccio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093203465 PECOS PAC ID: 3072862960 Enrollment ID: I20180827002134 |
| Provider Name | Beatrice Okoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497145023 PECOS PAC ID: 7618227851 Enrollment ID: I20180907002733 |
| Provider Name | Adam J Mctighe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578964979 PECOS PAC ID: 9032469275 Enrollment ID: I20180908000003 |
| Provider Name | Candance Morley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346640851 PECOS PAC ID: 5193075018 Enrollment ID: I20180913001453 |
| Provider Name | Rodrigo Falcao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023266426 PECOS PAC ID: 6507015872 Enrollment ID: I20180921001116 |
| Provider Name | Richard A Onoja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013493089 PECOS PAC ID: 4688926272 Enrollment ID: I20181009003460 |
| Provider Name | Enika Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427576776 PECOS PAC ID: 4587916762 Enrollment ID: I20181017000222 |
| Provider Name | Latoyia Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851891873 PECOS PAC ID: 2567715428 Enrollment ID: I20181024000275 |
| Provider Name | Tayanau Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881192805 PECOS PAC ID: 7810240603 Enrollment ID: I20181024001829 |
| Provider Name | Jill Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013467570 PECOS PAC ID: 7315290723 Enrollment ID: I20181101002397 |
| Provider Name | Barbara Lopes Cardozo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972839371 PECOS PAC ID: 1153674353 Enrollment ID: I20181105000615 |
| Provider Name | Patrice M Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285027177 PECOS PAC ID: 3779837489 Enrollment ID: I20181115002707 |
| Provider Name | Olajide Fawehinmi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639518780 PECOS PAC ID: 6103060371 Enrollment ID: I20181116001636 |
| Provider Name | Katina Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629429212 PECOS PAC ID: 6204180680 Enrollment ID: I20181121002378 |
| Provider Name | Rachel Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255776357 PECOS PAC ID: 2264776491 Enrollment ID: I20181129000553 |
| Provider Name | Stephanie Sizemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467920355 PECOS PAC ID: 5395089981 Enrollment ID: I20181210000329 |
| Provider Name | Latasha Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497296263 PECOS PAC ID: 8325382922 Enrollment ID: I20181210000633 |
| Provider Name | Curtisia D Town |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952552689 PECOS PAC ID: 7719042977 Enrollment ID: I20181210001459 |
| Provider Name | Meredith Mcwhirter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760987002 PECOS PAC ID: 8022353309 Enrollment ID: I20181213002666 |
| Provider Name | Jason M Jian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265663983 PECOS PAC ID: 5395997746 Enrollment ID: I20190110003557 |
| Provider Name | Karl Smart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124295332 PECOS PAC ID: 4587983861 Enrollment ID: I20190111001789 |
| Provider Name | Akeela Dossa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396222121 PECOS PAC ID: 2062759533 Enrollment ID: I20190123000803 |
| Provider Name | Darnae Michelle Lovett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851867568 PECOS PAC ID: 6709123961 Enrollment ID: I20190125000279 |
| Provider Name | Hannah Leann Naude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417454034 PECOS PAC ID: 5991043713 Enrollment ID: I20190220001561 |
| Provider Name | Sabitha Aligeti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457648461 PECOS PAC ID: 0840507265 Enrollment ID: I20190306001015 |
| Provider Name | Kathryn V Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841686193 PECOS PAC ID: 6507105616 Enrollment ID: I20190307002724 |
| Provider Name | Tara Fountain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356895353 PECOS PAC ID: 8022350156 Enrollment ID: I20190422000153 |
| Provider Name | Hardie Tatman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801208145 PECOS PAC ID: 2264774975 Enrollment ID: I20190430000381 |
| Provider Name | Jason E Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083171326 PECOS PAC ID: 9830431469 Enrollment ID: I20190501002834 |
| Provider Name | Mahlet Abebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750827242 PECOS PAC ID: 8820330343 Enrollment ID: I20190503000356 |
| Provider Name | Lan Tran Schlecht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386108587 PECOS PAC ID: 7810230414 Enrollment ID: I20190523000275 |
| Provider Name | Jasmine Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912460601 PECOS PAC ID: 1355674912 Enrollment ID: I20190613000966 |
| Provider Name | Sydney Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902322902 PECOS PAC ID: 3375876816 Enrollment ID: I20190614001356 |
| Provider Name | Aleema S Zakers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649610544 PECOS PAC ID: 0345582094 Enrollment ID: I20190619001393 |
| Provider Name | James E Ragazino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457747503 PECOS PAC ID: 5799080354 Enrollment ID: I20190726002527 |
| Provider Name | Matachi M Ughwanogho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639677529 PECOS PAC ID: 0042546152 Enrollment ID: I20190726002913 |
| Provider Name | Priscilla N Chukwueke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710918933 PECOS PAC ID: 7416939988 Enrollment ID: I20190816002603 |
| Provider Name | Yakov Rubinchik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548670144 PECOS PAC ID: 3577891209 Enrollment ID: I20190820000947 |
| Provider Name | Tyrone M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548729080 PECOS PAC ID: 4880922541 Enrollment ID: I20190820002101 |
| Provider Name | Tuvia Breuer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467665703 PECOS PAC ID: 6305962838 Enrollment ID: I20190824000294 |
| Provider Name | Hector A Diez Caballero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639321250 PECOS PAC ID: 1153586334 Enrollment ID: I20190826003574 |
| Provider Name | D. Kristine Nickel-gayle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952468332 PECOS PAC ID: 8325358302 Enrollment ID: I20190909003080 |
| Provider Name | Timothy Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073175378 PECOS PAC ID: 2062742885 Enrollment ID: I20190920003078 |
| Provider Name | Prabhakar Pisipati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649276437 PECOS PAC ID: 8527001619 Enrollment ID: I20190926003295 |
| Provider Name | Kurtis M Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134465263 PECOS PAC ID: 3173761954 Enrollment ID: I20190929000012 |
| Provider Name | Alana Cox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033230305 PECOS PAC ID: 2163752320 Enrollment ID: I20191001002715 |
| Provider Name | Angela Hamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063938074 PECOS PAC ID: 7810228293 Enrollment ID: I20191016001901 |
| Provider Name | Allison Gilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124674999 PECOS PAC ID: 7810229713 Enrollment ID: I20191025001569 |
| Provider Name | Mary Ann Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710457247 PECOS PAC ID: 9133451057 Enrollment ID: I20191025002368 |
| Provider Name | Helaina Jaffe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770978256 PECOS PAC ID: 5395047690 Enrollment ID: I20191111002349 |
| Provider Name | Brian Teal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215285028 PECOS PAC ID: 3678871183 Enrollment ID: I20191115001419 |
| Provider Name | Sanjeev Rally |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700152378 PECOS PAC ID: 7618271362 Enrollment ID: I20191115001667 |
| Provider Name | Gail Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780238204 PECOS PAC ID: 6002248788 Enrollment ID: I20191119000227 |
| Provider Name | Constance Francis-agalaba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760035414 PECOS PAC ID: 7012349426 Enrollment ID: I20191122001028 |
| Provider Name | Korinne L Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235639535 PECOS PAC ID: 5496187817 Enrollment ID: I20191122001394 |
| Provider Name | Rosetta A Friday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437669041 PECOS PAC ID: 3779916572 Enrollment ID: I20191210000339 |
| Provider Name | Tiffany Way |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265783146 PECOS PAC ID: 1355774894 Enrollment ID: I20191213001516 |
| Provider Name | Aju Varghese Alex |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215490693 PECOS PAC ID: 7012250871 Enrollment ID: I20191221000005 |
| Provider Name | Elizabeth South |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881259968 PECOS PAC ID: 4284068438 Enrollment ID: I20191223001248 |
| Provider Name | Jennifer H Simonds |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1437477262 PECOS PAC ID: 4385878594 Enrollment ID: I20200114000592 |
| Provider Name | Shaji J Puthuvel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780872481 PECOS PAC ID: 4082892302 Enrollment ID: I20200123002199 |
| Provider Name | August Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700218203 PECOS PAC ID: 0941637433 Enrollment ID: I20200221002310 |
| Provider Name | Susan Player |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1972742047 PECOS PAC ID: 6800223256 Enrollment ID: I20200224001933 |
| Provider Name | Dartiss M Chevalier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801434691 PECOS PAC ID: 6901233295 Enrollment ID: I20200226001829 |
| Provider Name | Jovon Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295372696 PECOS PAC ID: 9234567926 Enrollment ID: I20200311001332 |
| Provider Name | Linda Carter-sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982245460 PECOS PAC ID: 2365870060 Enrollment ID: I20200311001699 |
| Provider Name | Omoniyi Fatai Mutiu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396247359 PECOS PAC ID: 8022369776 Enrollment ID: I20200323002145 |
| Provider Name | Alexis C R Kessen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932353331 PECOS PAC ID: 9032380902 Enrollment ID: I20200401001842 |
| Provider Name | Robbie W Geiselman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346349784 PECOS PAC ID: 2769432095 Enrollment ID: I20200401001942 |
| Provider Name | Char'niece S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558900993 PECOS PAC ID: 7810326485 Enrollment ID: I20200402000111 |
| Provider Name | Kenyotter Whipple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356755128 PECOS PAC ID: 1759710965 Enrollment ID: I20200408003520 |
| Provider Name | Rohini Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326456625 PECOS PAC ID: 1153751805 Enrollment ID: I20200420002200 |
| Provider Name | Darin Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932741576 PECOS PAC ID: 5890125298 Enrollment ID: I20200427002577 |
| Provider Name | Alfiya James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376082461 PECOS PAC ID: 9032540208 Enrollment ID: I20200504002422 |
| Provider Name | Avis Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740611235 PECOS PAC ID: 4789015892 Enrollment ID: I20200505001890 |
| Provider Name | Ashley M King |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366821464 PECOS PAC ID: 2567893480 Enrollment ID: I20200509000165 |
| Provider Name | Kimberly Stubbs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386024792 PECOS PAC ID: 5890009740 Enrollment ID: I20200609003294 |
| Provider Name | Ebele Catherine Compean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033591979 PECOS PAC ID: 4587953286 Enrollment ID: I20200622000323 |
| Provider Name | Beatrice Odero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194358754 PECOS PAC ID: 9436571130 Enrollment ID: I20200625003157 |
| Provider Name | Jere Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821634957 PECOS PAC ID: 2961824404 Enrollment ID: I20200629003993 |
| Provider Name | Maria Gonzalez-iglesias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093080970 PECOS PAC ID: 4082038203 Enrollment ID: I20200721003587 |
| Provider Name | Barbara Campbell-antoine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366695249 PECOS PAC ID: 7618391376 Enrollment ID: I20200728001959 |
| Provider Name | Anna Sturkie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437531142 PECOS PAC ID: 6507281995 Enrollment ID: I20200731002750 |
| Provider Name | Kelly Thorpe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295343291 PECOS PAC ID: 7113345828 Enrollment ID: I20200911002478 |
| Provider Name | Catherine Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952911976 PECOS PAC ID: 5496173585 Enrollment ID: I20200922003121 |
| Provider Name | Heather Bernard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326506940 PECOS PAC ID: 1759700669 Enrollment ID: I20200925002060 |
| Provider Name | Ritu Chadha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730395260 PECOS PAC ID: 1557781200 Enrollment ID: I20201019000736 |
| Provider Name | Alexandria Marie Mason |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962035303 PECOS PAC ID: 5991136053 Enrollment ID: I20201030000104 |
| Provider Name | Bionca Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508429861 PECOS PAC ID: 8123438884 Enrollment ID: I20201109000820 |
| Provider Name | Jay Y. Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831546803 PECOS PAC ID: 1951698521 Enrollment ID: I20201110001996 |
| Provider Name | Terri Barton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366583189 PECOS PAC ID: 8022429257 Enrollment ID: I20201119001537 |
| Provider Name | Kun Tang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275849440 PECOS PAC ID: 1254559404 Enrollment ID: I20201125001834 |
| Provider Name | Simran Brar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659781870 PECOS PAC ID: 3870880685 Enrollment ID: I20201130002224 |
| Provider Name | Raven Little John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407387665 PECOS PAC ID: 9537570239 Enrollment ID: I20201202001012 |
| Provider Name | Magdalene Vasconez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265035158 PECOS PAC ID: 9335552447 Enrollment ID: I20210111001455 |
| Provider Name | Ann Marie Buchanan Cummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760417810 PECOS PAC ID: 9032522008 Enrollment ID: I20210112001793 |
| Provider Name | Meah Mccray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326676438 PECOS PAC ID: 1951715119 Enrollment ID: I20210128003023 |
| Provider Name | Bunmi Ogungbeje |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386065027 PECOS PAC ID: 3476967472 Enrollment ID: I20210203001290 |
| Provider Name | Jennifer Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194335620 PECOS PAC ID: 8820403652 Enrollment ID: I20210209000648 |
| Provider Name | Tricia Rumble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477117919 PECOS PAC ID: 3072845262 Enrollment ID: I20210212002188 |
| Provider Name | Heather Lowery Griffin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578945937 PECOS PAC ID: 4587954219 Enrollment ID: I20210215000475 |
| Provider Name | Sheeba Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154923563 PECOS PAC ID: 1355756859 Enrollment ID: I20210216000357 |
| Provider Name | Toyin O Adekunle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063073153 PECOS PAC ID: 9739594185 Enrollment ID: I20210216002780 |
| Provider Name | Fatimat Olumayowa Olufunmilayo Agbojeyin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477189157 PECOS PAC ID: 0749696110 Enrollment ID: I20210309002738 |
| Provider Name | Jamie Mccracken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750991592 PECOS PAC ID: 1759797764 Enrollment ID: I20210316002599 |
| Provider Name | Sameer V Dongre |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336582501 PECOS PAC ID: 4284933649 Enrollment ID: I20210317000297 |
| Provider Name | Stacy Wideman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386243871 PECOS PAC ID: 7416363478 Enrollment ID: I20210317001383 |
| Provider Name | Karina Lydia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831659317 PECOS PAC ID: 2769899483 Enrollment ID: I20210325000532 |
| Provider Name | Jenny L. Yancey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457684821 PECOS PAC ID: 2466874847 Enrollment ID: I20210408001983 |
| Provider Name | Jonathan Lee Hulkower |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063597961 PECOS PAC ID: 0749323343 Enrollment ID: I20210413000691 |
| Provider Name | Julie Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689276479 PECOS PAC ID: 2062820855 Enrollment ID: I20210415001498 |
| Provider Name | Michelle Dade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811460967 PECOS PAC ID: 9537577333 Enrollment ID: I20210415001896 |
| Provider Name | Lakia Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881290336 PECOS PAC ID: 7214345057 Enrollment ID: I20210416000426 |
| Provider Name | Courtney Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013550912 PECOS PAC ID: 5698108470 Enrollment ID: I20210422000777 |
| Provider Name | Tamela L Burton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225472905 PECOS PAC ID: 9931481330 Enrollment ID: I20210422001582 |
| Provider Name | Joyln Ferrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457888679 PECOS PAC ID: 4880002104 Enrollment ID: I20210426001024 |
| Provider Name | Audline M Hodnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336740398 PECOS PAC ID: 5092124214 Enrollment ID: I20210429000542 |
| Provider Name | Deola Saheed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972008381 PECOS PAC ID: 5799185989 Enrollment ID: I20210609001844 |
| Provider Name | Joshua Deal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780032771 PECOS PAC ID: 1456647999 Enrollment ID: I20210611001752 |
| Provider Name | Andrea M Fritschle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942386032 PECOS PAC ID: 0941385835 Enrollment ID: I20210614002320 |
| Provider Name | Cynthia Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275977589 PECOS PAC ID: 2668573007 Enrollment ID: I20210616003213 |
| Provider Name | Quinshunda Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871763805 PECOS PAC ID: 3173925682 Enrollment ID: I20210707000447 |
| Provider Name | Dolapo Abiodun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780076182 PECOS PAC ID: 1153723911 Enrollment ID: I20210715003276 |
| Provider Name | Kimberly Jean Reynolds-solar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598007775 PECOS PAC ID: 8729363437 Enrollment ID: I20210811001588 |
| Provider Name | Westlynn Benton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841612991 PECOS PAC ID: 0446654511 Enrollment ID: I20210811002676 |
| Provider Name | Brandi Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013516608 PECOS PAC ID: 2466856497 Enrollment ID: I20210812000835 |
| Provider Name | Emily Klein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861871964 PECOS PAC ID: 9335543305 Enrollment ID: I20210812003026 |
| Provider Name | Nichole Robeson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699012286 PECOS PAC ID: 0941605026 Enrollment ID: I20210827001334 |
| Provider Name | Nikita J Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861055717 PECOS PAC ID: 5395172522 Enrollment ID: I20210907000457 |
| Provider Name | Zacarias Yanis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194213140 PECOS PAC ID: 4981953429 Enrollment ID: I20210914000532 |
| Provider Name | Hannah Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104467356 PECOS PAC ID: 0840697660 Enrollment ID: I20210921003770 |
| Provider Name | Stefanie T Livingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487015376 PECOS PAC ID: 5395018386 Enrollment ID: I20210924001284 |
| Provider Name | Krishmaa Jendayi-robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184215923 PECOS PAC ID: 8527456128 Enrollment ID: I20211102000210 |
| Provider Name | Jessica Lane Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093387664 PECOS PAC ID: 1759770126 Enrollment ID: I20211105002205 |
| Provider Name | Ronald Soelimto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194252783 PECOS PAC ID: 5991069106 Enrollment ID: I20211111001321 |
| Provider Name | Misty Nicole Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831760255 PECOS PAC ID: 8224430293 Enrollment ID: I20211227001039 |
| Provider Name | Janese Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083370480 PECOS PAC ID: 8820489933 Enrollment ID: I20211228002270 |
| Provider Name | Omotayo Abdul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417623984 PECOS PAC ID: 0749671477 Enrollment ID: I20220106001316 |
| Provider Name | Jessica Igbalajobi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164004917 PECOS PAC ID: 6608269105 Enrollment ID: I20220204001603 |
| Provider Name | Shkeya Bellfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437811940 PECOS PAC ID: 3779977558 Enrollment ID: I20220221000651 |
| Provider Name | Kristen Erica Hunkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053807131 PECOS PAC ID: 0143568972 Enrollment ID: I20220302002000 |
| Provider Name | Marcia Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568907822 PECOS PAC ID: 0244624369 Enrollment ID: I20220304002025 |
| Provider Name | Sheeba Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023285848 PECOS PAC ID: 7214183680 Enrollment ID: I20220404000083 |
| Provider Name | Dara A Delancy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821289877 PECOS PAC ID: 7214160282 Enrollment ID: I20220426000406 |
| Provider Name | Brandon Landry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003569989 PECOS PAC ID: 1557748894 Enrollment ID: I20220506001315 |
| Provider Name | Doris Elonu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700376282 PECOS PAC ID: 6103203161 Enrollment ID: I20220512000477 |
| Provider Name | Colleen M Dougherty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033578000 PECOS PAC ID: 0446637185 Enrollment ID: I20220518000584 |
| Provider Name | Jacquelyne R Bodea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225100118 PECOS PAC ID: 2264570472 Enrollment ID: I20220525000233 |
| Provider Name | Shawn Kade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033866371 PECOS PAC ID: 1153700844 Enrollment ID: I20220627002718 |
| Provider Name | Amara Onuorah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700477981 PECOS PAC ID: 6608256144 Enrollment ID: I20220630001558 |
| Provider Name | Laura H White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265883730 PECOS PAC ID: 5193108868 Enrollment ID: I20220812000493 |
| Provider Name | Shannon Hummel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043959372 PECOS PAC ID: 2769865146 Enrollment ID: I20220817003158 |
| Provider Name | Andrew Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558095497 PECOS PAC ID: 9133503139 Enrollment ID: I20220824003267 |
| Provider Name | Marie E Gehle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922343953 PECOS PAC ID: 3375927189 Enrollment ID: I20220829000569 |
| Provider Name | Allison Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538894951 PECOS PAC ID: 8729462023 Enrollment ID: I20220906002761 |
| Provider Name | Clark Hawkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649627886 PECOS PAC ID: 4789926627 Enrollment ID: I20220919000697 |
| Provider Name | Matthew Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205150794 PECOS PAC ID: 0749546984 Enrollment ID: I20220920002195 |
| Provider Name | Nicole Silvernail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386371052 PECOS PAC ID: 9436534724 Enrollment ID: I20220922003417 |
| Provider Name | Mary Gladney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902536469 PECOS PAC ID: 1153707740 Enrollment ID: I20221005002078 |
| Provider Name | Omoyeme A Ehizuelen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033844998 PECOS PAC ID: 7416333018 Enrollment ID: I20221005002208 |
| Provider Name | Katherine L Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649346099 PECOS PAC ID: 1951777010 Enrollment ID: I20221014002352 |
| Provider Name | Anthony Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558904169 PECOS PAC ID: 9436564085 Enrollment ID: I20221127000031 |
| Provider Name | Amy Welch Holsten |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053665356 PECOS PAC ID: 4789811761 Enrollment ID: I20230106001393 |
| Provider Name | Jeffrey Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962510313 PECOS PAC ID: 0446622724 Enrollment ID: I20230215000139 |
| Provider Name | Samantha Danielle Zeisloft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417626490 PECOS PAC ID: 7214317486 Enrollment ID: I20230221002813 |
| Provider Name | Carmen G Savelli Hermann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942917356 PECOS PAC ID: 6204209778 Enrollment ID: I20230302003168 |
| Provider Name | Courtney Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508241472 PECOS PAC ID: 9638574361 Enrollment ID: I20230306002134 |
| Provider Name | Crystal M Lilavois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255067005 PECOS PAC ID: 8224401633 Enrollment ID: I20230306002806 |
| Provider Name | Darren D Stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679249650 PECOS PAC ID: 3577936996 Enrollment ID: I20230307000144 |
| Provider Name | Tonya Delaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104523075 PECOS PAC ID: 9335512516 Enrollment ID: I20230309001107 |
| Provider Name | Clifford A Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841625803 PECOS PAC ID: 8628387693 Enrollment ID: I20230309001566 |
| Provider Name | Christine E Liss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356093702 PECOS PAC ID: 0042684763 Enrollment ID: I20230321000993 |
| Provider Name | Rholonda Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407571425 PECOS PAC ID: 9931573532 Enrollment ID: I20230322001612 |
| Provider Name | Amy Syen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043759889 PECOS PAC ID: 6608240155 Enrollment ID: I20230323001262 |
| Provider Name | Nafiha N Islam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255821559 PECOS PAC ID: 3577816198 Enrollment ID: I20230324001755 |
| Provider Name | Vinoda Makam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114936671 PECOS PAC ID: 1850765058 Enrollment ID: I20230329000950 |
| Provider Name | Chinyere Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467954537 PECOS PAC ID: 7719342294 Enrollment ID: I20230505001965 |
| Provider Name | Valentina Asamaigor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598347106 PECOS PAC ID: 4284090564 Enrollment ID: I20230510003493 |
| Provider Name | Tiffany Kava Wu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174179576 PECOS PAC ID: 5991137663 Enrollment ID: I20230515000646 |
| Provider Name | Andrea R Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578232443 PECOS PAC ID: 4880052190 Enrollment ID: I20230620000057 |
| Provider Name | Jeanette A Gilles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790474492 PECOS PAC ID: 4082073457 Enrollment ID: I20230703000287 |
| Provider Name | Kahari J Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609583152 PECOS PAC ID: 4587023957 Enrollment ID: I20230703000486 |
| Provider Name | Tam T Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609539618 PECOS PAC ID: 1850750159 Enrollment ID: I20230705001733 |
| Provider Name | Krista R Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629709100 PECOS PAC ID: 3577923184 Enrollment ID: I20230714000110 |
| Provider Name | Cara Kelly O'brien Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053052258 PECOS PAC ID: 1052772555 Enrollment ID: I20230801000290 |
| Provider Name | Kymberly A Sampson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851040042 PECOS PAC ID: 5092179416 Enrollment ID: I20230918002496 |
| Provider Name | Brian Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043591183 PECOS PAC ID: 4385090497 Enrollment ID: I20231026000244 |
| Provider Name | Michael J Credidio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669536405 PECOS PAC ID: 9436505567 Enrollment ID: I20231026001388 |
| Provider Name | Antoinette Dion Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528127594 PECOS PAC ID: 7719217967 Enrollment ID: I20231031002746 |
| Provider Name | Linda A Evans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750381034 PECOS PAC ID: 6406824580 Enrollment ID: I20231102000802 |
| Provider Name | Ester T Pulliam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184978785 PECOS PAC ID: 7113156423 Enrollment ID: I20231102000918 |
| Provider Name | Lovelyne Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104385863 PECOS PAC ID: 4880042209 Enrollment ID: I20231127000458 |
| Provider Name | Irene Perry Wood |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1073806949 PECOS PAC ID: 6305295304 Enrollment ID: I20231215003395 |
| Provider Name | Donald Wayne Weatherford |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1427626670 PECOS PAC ID: 4385094200 Enrollment ID: I20231219000703 |
| Provider Name | Ammereta Leanna Gaskin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1366946154 PECOS PAC ID: 8426409541 Enrollment ID: I20240112001451 |
| Provider Name | Kristne Danielle Broadway |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1255875373 PECOS PAC ID: 6901257039 Enrollment ID: I20240112001758 |
| Provider Name | Courtney Greene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548914823 PECOS PAC ID: 7719339613 Enrollment ID: I20240116003665 |
| Provider Name | Kathryn Thompson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184022857 PECOS PAC ID: 6709238355 Enrollment ID: I20240118003382 |
| Provider Name | Maegan Yvonne Stuart |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1447640990 PECOS PAC ID: 0446602056 Enrollment ID: I20240119000770 |
| Provider Name | Kathryn Lynne Bobowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700240876 PECOS PAC ID: 8022460500 Enrollment ID: I20240119003179 |
| Provider Name | Kimberly Lynn Roth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942323100 PECOS PAC ID: 7911359344 Enrollment ID: I20240122000871 |
| Provider Name | Maudesta Scott Caleb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518511740 PECOS PAC ID: 6901258342 Enrollment ID: I20240122000965 |
| Provider Name | Andriea W Washington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427548825 PECOS PAC ID: 2365894532 Enrollment ID: I20240124000045 |
| Provider Name | John A Adegboye |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639766553 PECOS PAC ID: 8921450107 Enrollment ID: I20240124000284 |
| Provider Name | Tracy Ann Carmichael |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669837969 PECOS PAC ID: 9638522436 Enrollment ID: I20240129001606 |
| Provider Name | Angela Renee Poole |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558400879 PECOS PAC ID: 8022461862 Enrollment ID: I20240129003074 |
| Provider Name | Nathaniel Tucker Braddy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306420583 PECOS PAC ID: 0244683928 Enrollment ID: I20240130000317 |
| Provider Name | Michele Cookieanos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639621469 PECOS PAC ID: 1850744533 Enrollment ID: I20240130000406 |
| Provider Name | Azeezat Abisola Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447961164 PECOS PAC ID: 3072966654 Enrollment ID: I20240131000314 |
| Provider Name | Marybeth Adams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104491646 PECOS PAC ID: 9032562632 Enrollment ID: I20240131000776 |
| Provider Name | Megan Hope Caldwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457020513 PECOS PAC ID: 8820441421 Enrollment ID: I20240131000838 |
| Provider Name | Avis Francina China |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982872560 PECOS PAC ID: 3870946338 Enrollment ID: I20240131003277 |
| Provider Name | Sarah Kathleen Batzel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053012138 PECOS PAC ID: 7012360431 Enrollment ID: I20240201000526 |
| Provider Name | Panagiota Papamichali Overbey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548596869 PECOS PAC ID: 7214370311 Enrollment ID: I20240206001505 |
| Provider Name | Quitman John Brigmond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013471028 PECOS PAC ID: 1456794395 Enrollment ID: I20240208000790 |
| Provider Name | Katherine Elizabeth Adams |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568019487 PECOS PAC ID: 8224471065 Enrollment ID: I20240208000963 |
| Provider Name | Tamecia Latoya Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912260068 PECOS PAC ID: 5597108118 Enrollment ID: I20240209002781 |
| Provider Name | Joanna Mann Crockett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982265294 PECOS PAC ID: 9335582717 Enrollment ID: I20240213002840 |
| Provider Name | Lisa Rodgers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518026038 PECOS PAC ID: 9335583772 Enrollment ID: I20240214000611 |
| Provider Name | Benjamin Jeremy Hinote |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063836344 PECOS PAC ID: 4486098738 Enrollment ID: I20240215000139 |
| Provider Name | Shannon Ann Keller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952521650 PECOS PAC ID: 5799129821 Enrollment ID: I20240216002737 |
| Provider Name | Suwanne Taquise Sancko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336752195 PECOS PAC ID: 2961846019 Enrollment ID: I20240216003254 |
| Provider Name | Laurelanne Hackinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922609221 PECOS PAC ID: 1850735812 Enrollment ID: I20240216004350 |
| Provider Name | Christy J Gardner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215398771 PECOS PAC ID: 0648614396 Enrollment ID: I20240221001232 |
| Provider Name | Tamara Kathleen England Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376316216 PECOS PAC ID: 3971947516 Enrollment ID: I20240222000342 |
| Provider Name | Jenise Tehvon Greene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255042495 PECOS PAC ID: 7618311291 Enrollment ID: I20240222001831 |
| Provider Name | Consuela Bertina Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538441274 PECOS PAC ID: 8921442518 Enrollment ID: I20240222002076 |
| Provider Name | Nicole Mills |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699130831 PECOS PAC ID: 4385088897 Enrollment ID: I20240222003093 |
| Provider Name | Cynthia Ann Edins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710177241 PECOS PAC ID: 5890139315 Enrollment ID: I20240222003258 |
| Provider Name | Jasmine Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699365783 PECOS PAC ID: 5395189815 Enrollment ID: I20240222003441 |
| Provider Name | Debra Aiken Fain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871988600 PECOS PAC ID: 5991149478 Enrollment ID: I20240223001363 |
| Provider Name | Elizabeth M Haines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659952612 PECOS PAC ID: 6800230384 Enrollment ID: I20240223001367 |
| Provider Name | Shaqutia Shena Florence |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376122267 PECOS PAC ID: 5294179784 Enrollment ID: I20240223001595 |
| Provider Name | Deeveria Ashton Lacy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336641547 PECOS PAC ID: 8820433329 Enrollment ID: I20240223002396 |
| Provider Name | Jihene Ayadi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326786724 PECOS PAC ID: 6406291806 Enrollment ID: I20240226000814 |
| Provider Name | Genevieve Brienne Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104537380 PECOS PAC ID: 6002251170 Enrollment ID: I20240228002200 |
| Provider Name | Marion Lynne Chapman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306444351 PECOS PAC ID: 6901241975 Enrollment ID: I20240229001199 |
| Provider Name | Daniela Andronic |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760730055 PECOS PAC ID: 5698110682 Enrollment ID: I20240229002110 |
| Provider Name | Grayson Leigh West |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861034332 PECOS PAC ID: 3971948985 Enrollment ID: I20240229002917 |
| Provider Name | Caroline Bozarth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053035436 PECOS PAC ID: 9335584234 Enrollment ID: I20240301001760 |
| Provider Name | Bethany Anne Barcomb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689245789 PECOS PAC ID: 6103261938 Enrollment ID: I20240301003231 |
| Provider Name | Cierra Nicole Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649995903 PECOS PAC ID: 2264877075 Enrollment ID: I20240304001028 |
| Provider Name | Ebonie Briana Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437610045 PECOS PAC ID: 6901241520 Enrollment ID: I20240305001235 |
| Provider Name | Sherita Jenkins Tartt |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1821546920 PECOS PAC ID: 9234574807 Enrollment ID: I20240305002966 |
| Provider Name | Alexandra Jean Moses |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063988434 PECOS PAC ID: 1052757622 Enrollment ID: I20240306002283 |
| Provider Name | Joseph Hugh Etheredge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649934407 PECOS PAC ID: 4385080753 Enrollment ID: I20240307001719 |
| Provider Name | Cocise Antranette Grace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114405057 PECOS PAC ID: 1254777337 Enrollment ID: I20240312000559 |
| Provider Name | Anna Cunningham Ingram |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962036996 PECOS PAC ID: 5092151084 Enrollment ID: I20240313000865 |
| Provider Name | Zicole Browne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033647235 PECOS PAC ID: 4688010424 Enrollment ID: I20240314002750 |
| Provider Name | Amanda Gail Geras |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487438420 PECOS PAC ID: 3173969938 Enrollment ID: I20240314003386 |
| Provider Name | Erin Michelle Richardson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699242875 PECOS PAC ID: 4880031574 Enrollment ID: I20240318000277 |
| Provider Name | Kelli Maria Gordy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215345376 PECOS PAC ID: 2163869868 Enrollment ID: I20240318000566 |
| Provider Name | Jaketa Leena Groves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376317487 PECOS PAC ID: 1254778715 Enrollment ID: I20240320002412 |
| Provider Name | Julia Corinne Simmons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538326855 PECOS PAC ID: 8527405703 Enrollment ID: I20240322004019 |
| Provider Name | Susan A Stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285007559 PECOS PAC ID: 7911344130 Enrollment ID: I20240325000532 |
| Provider Name | Nancy Cody Bankston |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639306699 PECOS PAC ID: 2466728316 Enrollment ID: I20240329001501 |
| Provider Name | Erica Atkinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750815395 PECOS PAC ID: 3274971809 Enrollment ID: I20240402002534 |
| Provider Name | Melanie Lindblade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598098378 PECOS PAC ID: 9133567613 Enrollment ID: I20240403000577 |
| Provider Name | Carol Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184029803 PECOS PAC ID: 0749507994 Enrollment ID: I20240404003024 |
| Provider Name | Myngnon Denise Walton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407522287 PECOS PAC ID: 7315385614 Enrollment ID: I20240405000807 |
| Provider Name | William Mcleod |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134611536 PECOS PAC ID: 8123466372 Enrollment ID: I20240405003345 |
| Provider Name | Julie Ann Salitros |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811530181 PECOS PAC ID: 1951749977 Enrollment ID: I20240409003950 |
| Provider Name | John J Schramm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629162102 PECOS PAC ID: 0345688289 Enrollment ID: I20240410003475 |
| Provider Name | Samantha Lashawn Mcgirt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457808289 PECOS PAC ID: 9234577123 Enrollment ID: I20240411000941 |
| Provider Name | Vesna Maile Lipkovic |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215445705 PECOS PAC ID: 1658710546 Enrollment ID: I20240411001517 |
| Provider Name | Andrea Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114666419 PECOS PAC ID: 3577902485 Enrollment ID: I20240411002328 |
| Provider Name | Meredith Jane Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952073777 PECOS PAC ID: 4688013014 Enrollment ID: I20240418002281 |
| Provider Name | Richard Scott Patterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699199976 PECOS PAC ID: 4183063308 Enrollment ID: I20240419002004 |
| Provider Name | Edward Arthur Hancock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548938822 PECOS PAC ID: 9931548013 Enrollment ID: I20240423000636 |
| Provider Name | Thomas Howard Hutchison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205480217 PECOS PAC ID: 6103266093 Enrollment ID: I20240425001323 |
| Provider Name | Kristi Stinson Durden, Lmft |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912417437 PECOS PAC ID: 1951741883 Enrollment ID: I20240425002920 |
| Provider Name | Allison Rains Layman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750734455 PECOS PAC ID: 6406296359 Enrollment ID: I20240425003414 |
| Provider Name | Morgan Lueck |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083097455 PECOS PAC ID: 8325488505 Enrollment ID: I20240506000266 |
| Provider Name | Kiesha Stanley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740641968 PECOS PAC ID: 7911347026 Enrollment ID: I20240506003195 |
| Provider Name | Kelley Dyanne Sproles |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972090538 PECOS PAC ID: 0648610758 Enrollment ID: I20240506003210 |
| Provider Name | Amanda Catherine Viola-brooke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851800270 PECOS PAC ID: 9931540911 Enrollment ID: I20240508000807 |
| Provider Name | Yolanda Seals |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467475194 PECOS PAC ID: 4385085216 Enrollment ID: I20240509002480 |
| Provider Name | Annuradha Vijayvargiya |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912348921 PECOS PAC ID: 8123469913 Enrollment ID: I20240510001265 |
| Provider Name | Laura Wagar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376161224 PECOS PAC ID: 3870934615 Enrollment ID: I20240510002992 |
| Provider Name | Ethel London |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295196186 PECOS PAC ID: 1658712310 Enrollment ID: I20240513000465 |
| Provider Name | Denise Nya Spear |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063186690 PECOS PAC ID: 5193166643 Enrollment ID: I20240515000213 |
| Provider Name | Dylan Marie Ruby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790060176 PECOS PAC ID: 7214378793 Enrollment ID: I20240515001247 |
| Provider Name | Stephanie Waller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508366287 PECOS PAC ID: 0143762096 Enrollment ID: I20240606001240 |
| Provider Name | Adrian Chearell Sago |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578030789 PECOS PAC ID: 3274075668 Enrollment ID: I20240613001209 |
Walk In The Light Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Country Club Dr, Suite 100 D, Stockbridge, GA 30281 Phone: 888-688-6954 Fax: 888-688-6951 | |
Vibert Psychiatric Solutions, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1080 Eagles Landing Pkwy, Stockbridge, GA 30281 Phone: 470-516-9950 Fax: 470-221-1821 | |
Georgia Counseling Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 245 Country Club Dr Bldg 100a, Stockbridge, GA 30281 Phone: 470-878-1359 Fax: 678-272-8702 | |
A Growth Place, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Wilson Rd, Suite 1, Stockbridge, GA 30281 Phone: 770-506-9575 Fax: 770-506-9369 | |
M. Christopher Griffith, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1129 Hospital Dr, Ste 3c, Stockbridge, GA 30281 Phone: 770-507-0860 Fax: 770-507-0863 | |
Neurocare Institute Of Georgia Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 135 Eagles Walk, Suite 150, Stockbridge, GA 30281 Phone: 678-289-8662 Fax: 678-289-8691 | |
First Response Counseling & Intervention Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6053 N Henry Blvd, Suite C, Stockbridge, GA 30281 Phone: 678-545-4285 |