Geriatric Psychiatric Services Pllc | |
9465 Counselors Row Suite 200 Indianapolis IN 46240-6423 | |
(586) 620-8100 | |
(866) 227-7418 |
Full Name | Geriatric Psychiatric Services Pllc |
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Speciality | Psychiatry & Neurology |
Location | 9465 Counselors Row, Indianapolis, Indiana |
Authorized Official Name and Position | Robert A Clemente (ADMIN DIRECTOR) |
Authorized Official Contact | 5866208100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Geriatric Psychiatric Services Pllc 28800 Ryan Rd Suite 320 Warren MI 48092-4272 Ph: (586) 620-8100 | Geriatric Psychiatric Services Pllc 9465 Counselors Row Suite 200 Indianapolis IN 46240-6423 Ph: (586) 620-8100 |
NPI Number | 1881834125 |
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Provider Enumeration Date | 02/26/2009 |
Last Update Date | 12/31/2014 |
Medicare PECOS PAC ID | 6204837388 |
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Medicare Enrollment ID | O20090424000362 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881834125 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Pollyanna C Vujovic |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437137221 PECOS PAC ID: 5395806855 Enrollment ID: I20081203000342 |
Provider Name | Dennis Peter Padla |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1295728921 PECOS PAC ID: 7517858046 Enrollment ID: I20140612000326 |
Provider Name | Tiffanie Barnes |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1841595931 PECOS PAC ID: 2860752003 Enrollment ID: I20180207001460 |
Provider Name | Leroy M Lambey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548754039 PECOS PAC ID: 9830448885 Enrollment ID: I20210601001398 |
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