| Great Lakes Psychology Group | |
|
6548 Town Center Dr Ste D Clarkston MI 48346 | |
| (800) 693-1916 | |
| (248) 605-3525 |
| Full Name | Great Lakes Psychology Group |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6548 Town Center Dr Ste D, Clarkston, Michigan |
| Authorized Official Name and Position | Richard Carl Kneip (PRESIDENT) |
| Authorized Official Contact | 2487012017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Psychology Group Po Box 772263 Detroit MI 48277-2263 Ph: (800) 693-1916 | Great Lakes Psychology Group 6548 Town Center Dr Ste D Clarkston MI 48346 Ph: (800) 693-1916 |
| NPI Number | 1679739700 |
|---|---|
| Provider Enumeration Date | 07/29/2008 |
| Last Update Date | 05/23/2023 |
| Certification Date | 05/23/2023 |
| Medicare PECOS PAC ID | 4880768415 |
|---|---|
| Medicare Enrollment ID | O20080731000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679739700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6301007060 (Michigan) | Primary |
| Provider Name | Yvette R Mccoy-rodgers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003524265 PECOS PAC ID: 4385543289 Enrollment ID: I20040108000511 |
| Provider Name | Richard C Kneip |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558495051 PECOS PAC ID: 2163406372 Enrollment ID: I20040615001730 |
| Provider Name | Megan P Vaccaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033126719 PECOS PAC ID: 4587643077 Enrollment ID: I20040719000031 |
| Provider Name | Rita A White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033292669 PECOS PAC ID: 3375516974 Enrollment ID: I20040812001289 |
| Provider Name | Carmelle Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811989429 PECOS PAC ID: 5193792851 Enrollment ID: I20040913000640 |
| Provider Name | Debra Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336276294 PECOS PAC ID: 7618932427 Enrollment ID: I20041122000236 |
| Provider Name | Matthew Bernard Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497701361 PECOS PAC ID: 5890741425 Enrollment ID: I20050328000395 |
| Provider Name | Stacey Krause |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801823208 PECOS PAC ID: 1254344203 Enrollment ID: I20060718000012 |
| Provider Name | Carla D Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649220732 PECOS PAC ID: 4385657717 Enrollment ID: I20060801000157 |
| Provider Name | Karen Anne Borruso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215027198 PECOS PAC ID: 2365545530 Enrollment ID: I20070308000057 |
| Provider Name | Vicky L Alvarez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013029362 PECOS PAC ID: 3678650256 Enrollment ID: I20080407000438 |
| Provider Name | Trisha Lyn Stock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225111057 PECOS PAC ID: 4385782440 Enrollment ID: I20091110000353 |
| Provider Name | Hollie Andrews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497949135 PECOS PAC ID: 5193867836 Enrollment ID: I20100119000632 |
| Provider Name | Amy L Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205067444 PECOS PAC ID: 0244429173 Enrollment ID: I20110107000819 |
| Provider Name | Daniel C Stettner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093821597 PECOS PAC ID: 6608055041 Enrollment ID: I20110201000121 |
| Provider Name | Carolyn G Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740371988 PECOS PAC ID: 4981882545 Enrollment ID: I20110629000750 |
| Provider Name | Karen Skrzypek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548527419 PECOS PAC ID: 5698924504 Enrollment ID: I20121010000236 |
| Provider Name | Kerry L Leahy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558556035 PECOS PAC ID: 4082857818 Enrollment ID: I20130827000517 |
| Provider Name | Sarah M Kraft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780012765 PECOS PAC ID: 9537397955 Enrollment ID: I20140110000676 |
| Provider Name | Patrick S Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013331651 PECOS PAC ID: 1052543105 Enrollment ID: I20140404000185 |
| Provider Name | Chalice M Kopacki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972922516 PECOS PAC ID: 6709019292 Enrollment ID: I20140508000375 |
| Provider Name | Dewanda L Gichemi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598983587 PECOS PAC ID: 1759506835 Enrollment ID: I20140703000665 |
| Provider Name | Nicole L Gilbertson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568794329 PECOS PAC ID: 4880811041 Enrollment ID: I20140812000489 |
| Provider Name | Julie Schaefer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578610473 PECOS PAC ID: 1850518903 Enrollment ID: I20140813001220 |
| Provider Name | Monica Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821339185 PECOS PAC ID: 3072836089 Enrollment ID: I20141224001043 |
| Provider Name | Kristin L Penix |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124416979 PECOS PAC ID: 1759604283 Enrollment ID: I20150108000610 |
| Provider Name | Nicole M Minty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982940839 PECOS PAC ID: 0345569331 Enrollment ID: I20150423002566 |
| Provider Name | Kehly L Syrkett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275867574 PECOS PAC ID: 2668792540 Enrollment ID: I20150515001264 |
| Provider Name | Samuel J Hobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346622701 PECOS PAC ID: 7214242668 Enrollment ID: I20150814013117 |
| Provider Name | Stephani R Weber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689927659 PECOS PAC ID: 3678880044 Enrollment ID: I20150917000271 |
| Provider Name | Nicholas D Weiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548514904 PECOS PAC ID: 0547579203 Enrollment ID: I20151020000368 |
| Provider Name | Crystal C Shilling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881957967 PECOS PAC ID: 5496055725 Enrollment ID: I20151118001754 |
| Provider Name | Amy Da Silva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528401254 PECOS PAC ID: 9931400124 Enrollment ID: I20151211001946 |
| Provider Name | Andrea K Kaput |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811338668 PECOS PAC ID: 4981905981 Enrollment ID: I20151216002148 |
| Provider Name | Shawnteal Pernell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861857799 PECOS PAC ID: 7416251467 Enrollment ID: I20160211000908 |
| Provider Name | Libby Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720452931 PECOS PAC ID: 2860796711 Enrollment ID: I20160212001573 |
| Provider Name | Heather R Bade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386918696 PECOS PAC ID: 0547565061 Enrollment ID: I20160222001627 |
| Provider Name | Elizabeth Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578990339 PECOS PAC ID: 7012212111 Enrollment ID: I20160229000388 |
| Provider Name | Rebecca L. Nowak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568879120 PECOS PAC ID: 0143526467 Enrollment ID: I20160314000997 |
| Provider Name | Earnestine Coates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396066908 PECOS PAC ID: 2163721911 Enrollment ID: I20160428000791 |
| Provider Name | Theresa Cooke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831288836 PECOS PAC ID: 1759680135 Enrollment ID: I20160506000723 |
| Provider Name | Mary L Cunniffe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518389147 PECOS PAC ID: 6204126642 Enrollment ID: I20160526000778 |
| Provider Name | Edyta S Krukowska-urban |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245352012 PECOS PAC ID: 0749570117 Enrollment ID: I20160526001818 |
| Provider Name | Shauna M Gulliver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295166379 PECOS PAC ID: 5698065811 Enrollment ID: I20160531002416 |
| Provider Name | Lina Escamilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639302458 PECOS PAC ID: 8224321237 Enrollment ID: I20160728001959 |
| Provider Name | Patricia M Imai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699225722 PECOS PAC ID: 5799063939 Enrollment ID: I20161024000922 |
| Provider Name | Nasreen R Meah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811348238 PECOS PAC ID: 7618258096 Enrollment ID: I20161222000820 |
| Provider Name | Jesse Bacon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548605173 PECOS PAC ID: 1658653373 Enrollment ID: I20170112002112 |
| Provider Name | Michele L Puzzuoli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619028040 PECOS PAC ID: 9638451461 Enrollment ID: I20170131000656 |
| Provider Name | Christy Houston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811327232 PECOS PAC ID: 7719260660 Enrollment ID: I20170220001500 |
| Provider Name | Shelia E Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134433329 PECOS PAC ID: 9032493937 Enrollment ID: I20170221000549 |
| Provider Name | Miko Jeffries |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346785680 PECOS PAC ID: 8224312756 Enrollment ID: I20170301001816 |
| Provider Name | James Wickersham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396106225 PECOS PAC ID: 1456635663 Enrollment ID: I20170308001067 |
| Provider Name | Megan B Linegar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053707588 PECOS PAC ID: 8921375098 Enrollment ID: I20170519001166 |
| Provider Name | Frank Almaflahi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427471002 PECOS PAC ID: 4880961366 Enrollment ID: I20170605002349 |
| Provider Name | Karyn L Skiba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841672987 PECOS PAC ID: 5698040293 Enrollment ID: I20171009000337 |
| Provider Name | Alexandra Lepsetz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518239987 PECOS PAC ID: 1355607540 Enrollment ID: I20171103000314 |
| Provider Name | Jennifer Ann Oles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407126030 PECOS PAC ID: 4385900356 Enrollment ID: I20171107002294 |
| Provider Name | Reema Beri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619360047 PECOS PAC ID: 2961760079 Enrollment ID: I20171219002365 |
| Provider Name | Meri Hopkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821525536 PECOS PAC ID: 6709145071 Enrollment ID: I20180111001884 |
| Provider Name | Andrea Lea Cassell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083136105 PECOS PAC ID: 1355609199 Enrollment ID: I20180125002382 |
| Provider Name | Nicole M Pettibone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679969752 PECOS PAC ID: 0244590578 Enrollment ID: I20180207000465 |
| Provider Name | Allyssa Machnik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649622150 PECOS PAC ID: 0446510226 Enrollment ID: I20180216001640 |
| Provider Name | Amanda M Kerbawy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326408238 PECOS PAC ID: 0547521163 Enrollment ID: I20180222001913 |
| Provider Name | Amber L.m. Hickman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154729275 PECOS PAC ID: 8527329143 Enrollment ID: I20180222001980 |
| Provider Name | Debra A Kusluski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427432830 PECOS PAC ID: 1759642960 Enrollment ID: I20180305001638 |
| Provider Name | Erica Springer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821484551 PECOS PAC ID: 8123380094 Enrollment ID: I20180313002185 |
| Provider Name | Brent Andrew Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447753215 PECOS PAC ID: 0345503991 Enrollment ID: I20180411002960 |
| Provider Name | Emily S Lemke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780093377 PECOS PAC ID: 4981926979 Enrollment ID: I20180521000352 |
| Provider Name | Nicole T Bonter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083111215 PECOS PAC ID: 0749536035 Enrollment ID: I20180628001420 |
| Provider Name | Serena E Eagan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982841052 PECOS PAC ID: 6406103852 Enrollment ID: I20180717002603 |
| Provider Name | Nicolette Cheff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740772193 PECOS PAC ID: 3971850827 Enrollment ID: I20180724000222 |
| Provider Name | Stephanie Brandimarte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811482342 PECOS PAC ID: 7012265283 Enrollment ID: I20180803001117 |
| Provider Name | Adnan H Jaber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740685411 PECOS PAC ID: 0345599171 Enrollment ID: I20180827003787 |
| Provider Name | Andrew Edward Moldenhauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881026284 PECOS PAC ID: 1951652122 Enrollment ID: I20180927000758 |
| Provider Name | Pamela Hyles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326522483 PECOS PAC ID: 5294088688 Enrollment ID: I20181101001567 |
| Provider Name | Gisela Rodriguez Lawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396245726 PECOS PAC ID: 7012261001 Enrollment ID: I20181109001388 |
| Provider Name | Chastidy Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114268208 PECOS PAC ID: 7012251366 Enrollment ID: I20181128000319 |
| Provider Name | Janice Dickerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942685961 PECOS PAC ID: 2567707037 Enrollment ID: I20190103000527 |
| Provider Name | Scott Becker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942418967 PECOS PAC ID: 6204173909 Enrollment ID: I20190201002021 |
| Provider Name | Nicholas Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003164245 PECOS PAC ID: 5496095101 Enrollment ID: I20190315001826 |
| Provider Name | Heather D Raitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477089829 PECOS PAC ID: 5991045288 Enrollment ID: I20190325000453 |
| Provider Name | Harvey Finkelberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134677974 PECOS PAC ID: 3971845546 Enrollment ID: I20190501000059 |
| Provider Name | Octavia C Amerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437524634 PECOS PAC ID: 6901149046 Enrollment ID: I20190514000108 |
| Provider Name | Tony Emerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316399496 PECOS PAC ID: 6002149614 Enrollment ID: I20190613003217 |
| Provider Name | Loretta Ann Carbone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013577840 PECOS PAC ID: 2365778479 Enrollment ID: I20190727000110 |
| Provider Name | Hilary A Slanec |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619415064 PECOS PAC ID: 1951630367 Enrollment ID: I20190910003902 |
| Provider Name | Brienne Hackett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811542442 PECOS PAC ID: 4880924513 Enrollment ID: I20190924001016 |
| Provider Name | Sharyl Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588215149 PECOS PAC ID: 5395076525 Enrollment ID: I20191018001879 |
| Provider Name | Stephanie Mewes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831642560 PECOS PAC ID: 8426380429 Enrollment ID: I20191024000231 |
| Provider Name | Sarah B David |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306128442 PECOS PAC ID: 0648603514 Enrollment ID: I20191206000770 |
| Provider Name | Patricia Lauren Berthelot |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689044406 PECOS PAC ID: 5496189128 Enrollment ID: I20200106000429 |
| Provider Name | Diana L Mousseau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497704449 PECOS PAC ID: 8921000688 Enrollment ID: I20200423000472 |
| Provider Name | Gina Shagena |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265945430 PECOS PAC ID: 5890125413 Enrollment ID: I20200423000506 |
| Provider Name | Lauren Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750628053 PECOS PAC ID: 1557791001 Enrollment ID: I20200423001759 |
| Provider Name | Judy Kotzen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134699077 PECOS PAC ID: 7810313665 Enrollment ID: I20200729000386 |
| Provider Name | Nicole A Holbrook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881102945 PECOS PAC ID: 6406273457 Enrollment ID: I20200904001616 |
| Provider Name | Daniel Grinberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366960361 PECOS PAC ID: 1557693694 Enrollment ID: I20200908001036 |
| Provider Name | Michael Lagrou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700104460 PECOS PAC ID: 4880012871 Enrollment ID: I20200908001067 |
| Provider Name | Wendi Rene Amburgey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427667260 PECOS PAC ID: 7810316171 Enrollment ID: I20201006001674 |
| Provider Name | Kathleen C Enersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154797322 PECOS PAC ID: 6002236270 Enrollment ID: I20201009001547 |
| Provider Name | Elizabeth Kronner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851835219 PECOS PAC ID: 3971923863 Enrollment ID: I20201014002634 |
| Provider Name | Helen Clairese Paulsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770948903 PECOS PAC ID: 8325458193 Enrollment ID: I20201105002060 |
| Provider Name | Yenju Lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831696335 PECOS PAC ID: 7214347947 Enrollment ID: I20201106002241 |
| Provider Name | Daniel Holdwick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710032685 PECOS PAC ID: 1254743958 Enrollment ID: I20201222002883 |
| Provider Name | Ryan Ashley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114165651 PECOS PAC ID: 6204079148 Enrollment ID: I20201223000865 |
| Provider Name | Martin Tobia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154779973 PECOS PAC ID: 4284040957 Enrollment ID: I20210303002218 |
| Provider Name | Sarina Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053920801 PECOS PAC ID: 8325454895 Enrollment ID: I20210308001682 |
| Provider Name | Joel C. Arnold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447714845 PECOS PAC ID: 1355758939 Enrollment ID: I20210326000647 |
| Provider Name | London Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790236263 PECOS PAC ID: 8921416603 Enrollment ID: I20210419000289 |
| Provider Name | Sherry Lee Pianko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720670961 PECOS PAC ID: 5890103493 Enrollment ID: I20210420002698 |
| Provider Name | Nathan Lloyd White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306320627 PECOS PAC ID: 1456769769 Enrollment ID: I20210426000821 |
| Provider Name | Sha'miya Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518487966 PECOS PAC ID: 9931517158 Enrollment ID: I20210427003037 |
| Provider Name | Kara Nicolosi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376012237 PECOS PAC ID: 3779992995 Enrollment ID: I20210429000801 |
| Provider Name | Jade M Dodde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356852529 PECOS PAC ID: 9537568860 Enrollment ID: I20210519000101 |
| Provider Name | Sarah Woodward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255840047 PECOS PAC ID: 4385043843 Enrollment ID: I20210603000993 |
| Provider Name | Amanda Ruth Danysh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598331928 PECOS PAC ID: 8527460468 Enrollment ID: I20210714001932 |
| Provider Name | Kaifa Alsoofy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811378672 PECOS PAC ID: 1254733199 Enrollment ID: I20210714001939 |
| Provider Name | Teraye Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750794210 PECOS PAC ID: 1153723093 Enrollment ID: I20210714001962 |
| Provider Name | Brooke June Ashley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821654914 PECOS PAC ID: 4880096726 Enrollment ID: I20210714001973 |
| Provider Name | Lorna Blakian Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801465034 PECOS PAC ID: 1153724299 Enrollment ID: I20210727000972 |
| Provider Name | Ciandra Syms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205258704 PECOS PAC ID: 8628471729 Enrollment ID: I20210727003490 |
| Provider Name | Cheryl Ann Breithaupt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235702713 PECOS PAC ID: 7416351036 Enrollment ID: I20210804001931 |
| Provider Name | Sara Joanne Sutherland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063004455 PECOS PAC ID: 5193129278 Enrollment ID: I20210811003057 |
| Provider Name | David Scott King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346574563 PECOS PAC ID: 3476958372 Enrollment ID: I20210816001633 |
| Provider Name | Paige Marie Neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033780176 PECOS PAC ID: 4587069158 Enrollment ID: I20210819001409 |
| Provider Name | Emily Mccrandall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144881525 PECOS PAC ID: 8325444391 Enrollment ID: I20210831002300 |
| Provider Name | Brenda M Wilcox-kronner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699440370 PECOS PAC ID: 9436555000 Enrollment ID: I20210907001878 |
| Provider Name | Quintin Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427423359 PECOS PAC ID: 0648678599 Enrollment ID: I20211007002562 |
| Provider Name | Julie Decoste |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205369675 PECOS PAC ID: 7113325598 Enrollment ID: I20211015000933 |
| Provider Name | Justin Gillespie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003420498 PECOS PAC ID: 6709276207 Enrollment ID: I20211123002400 |
| Provider Name | Jorden E Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982128286 PECOS PAC ID: 9133510415 Enrollment ID: I20211221000817 |
| Provider Name | Christina Diederichs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578844494 PECOS PAC ID: 8628469939 Enrollment ID: I20211221002069 |
| Provider Name | Bradley Allan Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083261705 PECOS PAC ID: 0648663419 Enrollment ID: I20220201000183 |
| Provider Name | Erin Williams Fisk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700134038 PECOS PAC ID: 1052704798 Enrollment ID: I20220202000718 |
| Provider Name | Rachael Eveline Norwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548819121 PECOS PAC ID: 5890188551 Enrollment ID: I20220202001512 |
| Provider Name | Samantha Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760041206 PECOS PAC ID: 9638455835 Enrollment ID: I20220211000361 |
| Provider Name | Janice R Hendricks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144792185 PECOS PAC ID: 5496140329 Enrollment ID: I20220311000718 |
| Provider Name | Nancy Carrara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679045710 PECOS PAC ID: 5496140907 Enrollment ID: I20220321000762 |
| Provider Name | Ashley Taylor Laine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154964641 PECOS PAC ID: 7315333978 Enrollment ID: I20220407000295 |
| Provider Name | Ashley Norton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215495262 PECOS PAC ID: 6507253044 Enrollment ID: I20220502000142 |
| Provider Name | Camille Joyce Sumpter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457646283 PECOS PAC ID: 0749677219 Enrollment ID: I20220502001203 |
| Provider Name | Stephanie Denise Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871008367 PECOS PAC ID: 5294112504 Enrollment ID: I20220506000375 |
| Provider Name | Amy C Naylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306374269 PECOS PAC ID: 2567849748 Enrollment ID: I20220509001122 |
| Provider Name | Andrea Lyn Flowers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265183016 PECOS PAC ID: 6901283548 Enrollment ID: I20220519001675 |
| Provider Name | Mark E Heim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285606103 PECOS PAC ID: 8628455268 Enrollment ID: I20220519001682 |
| Provider Name | Clara Throckmorton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477827830 PECOS PAC ID: 8921380304 Enrollment ID: I20220519002640 |
| Provider Name | Rachel Kornilakis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831729433 PECOS PAC ID: 4082095559 Enrollment ID: I20220714001431 |
| Provider Name | Erica Dionne Gaston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154779742 PECOS PAC ID: 2062893530 Enrollment ID: I20220714001505 |
| Provider Name | Margarethe Kerlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497319396 PECOS PAC ID: 6002297256 Enrollment ID: I20220719001771 |
| Provider Name | Lacey Trent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538593322 PECOS PAC ID: 5799106696 Enrollment ID: I20220719002437 |
| Provider Name | Nicole Takla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942946694 PECOS PAC ID: 4981085164 Enrollment ID: I20220719002772 |
| Provider Name | Sandra Dawn Flury-gardner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285105130 PECOS PAC ID: 2860873098 Enrollment ID: I20220720000728 |
| Provider Name | Jimmie Scott Woodward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811331879 PECOS PAC ID: 9436530557 Enrollment ID: I20220721000581 |
| Provider Name | Jeffrey Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184116113 PECOS PAC ID: 7719369313 Enrollment ID: I20220728002900 |
| Provider Name | Sherry Ann Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588038095 PECOS PAC ID: 9032591227 Enrollment ID: I20220804001621 |
| Provider Name | Patrick Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366418873 PECOS PAC ID: 1658267950 Enrollment ID: I20220815002265 |
| Provider Name | Stephanie Marie Maul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740832112 PECOS PAC ID: 7416332317 Enrollment ID: I20220913002648 |
| Provider Name | Courtney M Perritt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851707426 PECOS PAC ID: 9335524511 Enrollment ID: I20220924000096 |
| Provider Name | Jessica Renee-yi Warpup |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003536681 PECOS PAC ID: 3971989450 Enrollment ID: I20221006002334 |
| Provider Name | Yolanda Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699168948 PECOS PAC ID: 4789050485 Enrollment ID: I20221020003092 |
| Provider Name | Savannah Michelle Dakota |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447809058 PECOS PAC ID: 8022484690 Enrollment ID: I20221022000239 |
| Provider Name | Monica Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013459940 PECOS PAC ID: 4981071990 Enrollment ID: I20221104000173 |
| Provider Name | Lativia D Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033453139 PECOS PAC ID: 4385011303 Enrollment ID: I20221104000453 |
| Provider Name | Lori Anne George |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578119897 PECOS PAC ID: 9133596943 Enrollment ID: I20221108002574 |
| Provider Name | Matthew Greiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831780170 PECOS PAC ID: 0941678999 Enrollment ID: I20221122002077 |
| Provider Name | Sharon Killen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922296946 PECOS PAC ID: 6507234234 Enrollment ID: I20221130000672 |
| Provider Name | Marayah Garza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760920912 PECOS PAC ID: 2062881840 Enrollment ID: I20221219000720 |
| Provider Name | Alexis Nicole Tillery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215535117 PECOS PAC ID: 2567832074 Enrollment ID: I20221227002061 |
| Provider Name | Alayna Boomgaard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235746041 PECOS PAC ID: 3577936285 Enrollment ID: I20230228001706 |
| Provider Name | Jillian Cloutier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205553666 PECOS PAC ID: 5496128837 Enrollment ID: I20230306000421 |
| Provider Name | Kira Whitney Burnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265055016 PECOS PAC ID: 2769855907 Enrollment ID: I20230308002799 |
| Provider Name | Nancy Stevenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366807281 PECOS PAC ID: 6204209356 Enrollment ID: I20230310001112 |
| Provider Name | Amanda Rae Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508357195 PECOS PAC ID: 0840663928 Enrollment ID: I20230310002474 |
| Provider Name | Kayla Lee Strong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639678626 PECOS PAC ID: 1759754831 Enrollment ID: I20230310002476 |
| Provider Name | Natalie Marie Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215635842 PECOS PAC ID: 5799159638 Enrollment ID: I20230316001397 |
| Provider Name | Allison Stoddard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194137893 PECOS PAC ID: 6507230240 Enrollment ID: I20230321001852 |
| Provider Name | April Hitchcock-fofana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427496470 PECOS PAC ID: 4789058256 Enrollment ID: I20230323002340 |
| Provider Name | Kimberly Michelle Clemons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144568890 PECOS PAC ID: 5496129678 Enrollment ID: I20230330001217 |
| Provider Name | Evan Andrew Koehn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275905911 PECOS PAC ID: 0042685208 Enrollment ID: I20230331001982 |
| Provider Name | Layla Abada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982195608 PECOS PAC ID: 9234504127 Enrollment ID: I20230406000921 |
| Provider Name | Catherine Moritz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114586245 PECOS PAC ID: 0244605186 Enrollment ID: I20230407000140 |
| Provider Name | Kaitlyn Amanda Fetter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568992956 PECOS PAC ID: 2961877519 Enrollment ID: I20230412001946 |
| Provider Name | David Copeland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003399478 PECOS PAC ID: 3779958293 Enrollment ID: I20230413002107 |
| Provider Name | Norma Renee Schropshire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346937711 PECOS PAC ID: 4981069747 Enrollment ID: I20230430000099 |
| Provider Name | Gage Peavler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922691120 PECOS PAC ID: 5395100838 Enrollment ID: I20230505000309 |
| Provider Name | Melissa Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023789310 PECOS PAC ID: 7416314232 Enrollment ID: I20230608002423 |
| Provider Name | Barbara Orszolo Szymanski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639402431 PECOS PAC ID: 8729446422 Enrollment ID: I20230627002576 |
| Provider Name | Alicia Travis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043774565 PECOS PAC ID: 7517326630 Enrollment ID: I20230707002491 |
| Provider Name | Rene Ayanna Amsterdam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407476526 PECOS PAC ID: 0345609111 Enrollment ID: I20230711004092 |
| Provider Name | Todd Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366570582 PECOS PAC ID: 9931465887 Enrollment ID: I20230720000508 |
| Provider Name | Paul Joyner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154995801 PECOS PAC ID: 6103287974 Enrollment ID: I20230727000752 |
| Provider Name | Amanda Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275069866 PECOS PAC ID: 9335502350 Enrollment ID: I20230823004557 |
| Provider Name | Cerene Kole |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346921889 PECOS PAC ID: 4284098039 Enrollment ID: I20230912002056 |
| Provider Name | Vickie Clouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639655285 PECOS PAC ID: 8820444375 Enrollment ID: I20231019003045 |
| Provider Name | Jamie Rodda |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679959514 PECOS PAC ID: 9638526197 Enrollment ID: I20231106002918 |
| Provider Name | Kara Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073187902 PECOS PAC ID: 1759738172 Enrollment ID: I20231107001777 |
| Provider Name | Joel Damian Burnett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407374580 PECOS PAC ID: 9234587809 Enrollment ID: I20231121002326 |
| Provider Name | Nicole Griffith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437550431 PECOS PAC ID: 7113267121 Enrollment ID: I20231121002426 |
| Provider Name | Melanie A Tomalia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548738263 PECOS PAC ID: 1355799826 Enrollment ID: I20231121002631 |
| Provider Name | Bridget Lynn Marchese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447809439 PECOS PAC ID: 6800244377 Enrollment ID: I20231121002656 |
| Provider Name | Nicole Marie Lawson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699086462 PECOS PAC ID: 4789032251 Enrollment ID: I20231121002764 |
| Provider Name | Misty Lynne Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144772344 PECOS PAC ID: 9335573955 Enrollment ID: I20231121002798 |
| Provider Name | Nicole Potapa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447600291 PECOS PAC ID: 1759739220 Enrollment ID: I20231121002880 |
| Provider Name | Christina Arlene Brady |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780136580 PECOS PAC ID: 5092163568 Enrollment ID: I20231121003012 |
| Provider Name | Bernice Eppes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710382262 PECOS PAC ID: 5092163576 Enrollment ID: I20231121003052 |
| Provider Name | Laura Smigielski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154018893 PECOS PAC ID: 6507186533 Enrollment ID: I20231122000280 |
| Provider Name | Adrian Emerick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104240175 PECOS PAC ID: 4981052404 Enrollment ID: I20231122000747 |
| Provider Name | Elizabeth Marie Teklinski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316429863 PECOS PAC ID: 1951759489 Enrollment ID: I20231122000896 |
| Provider Name | Gennifer Manders |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245557354 PECOS PAC ID: 1052769593 Enrollment ID: I20231122001218 |
| Provider Name | Meltem Akbay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932599685 PECOS PAC ID: 4486002938 Enrollment ID: I20231122001724 |
| Provider Name | Wendala K. Klinski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023334380 PECOS PAC ID: 3971951286 Enrollment ID: I20231128000821 |
| Provider Name | Julie Kathleen Clark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164892873 PECOS PAC ID: 1254789597 Enrollment ID: I20231128001698 |
| Provider Name | April G Brandon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508326984 PECOS PAC ID: 5395193452 Enrollment ID: I20231129003631 |
| Provider Name | Karen Andrea Mueller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689753964 PECOS PAC ID: 0840648937 Enrollment ID: I20231130000448 |
| Provider Name | Carly Rothenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770259921 PECOS PAC ID: 9537518204 Enrollment ID: I20231207001645 |
| Provider Name | Amy M Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750660791 PECOS PAC ID: 2365891975 Enrollment ID: I20231207003348 |
| Provider Name | Candace Shuel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679080089 PECOS PAC ID: 4385093848 Enrollment ID: I20231208001425 |
| Provider Name | Karin Lynn Palombella |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356411722 PECOS PAC ID: 1850740119 Enrollment ID: I20231212001485 |
| Provider Name | Shelby Renee-guillory Mccliggott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790159168 PECOS PAC ID: 9739538026 Enrollment ID: I20231212002459 |
| Provider Name | Patrina G Pica-kras |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780713222 PECOS PAC ID: 3476902669 Enrollment ID: I20231213002315 |
| Provider Name | Jennifer L Muller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104402312 PECOS PAC ID: 1951751866 Enrollment ID: I20231219000586 |
| Provider Name | Julie Goodman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447432059 PECOS PAC ID: 7214387182 Enrollment ID: I20231219002683 |
| Provider Name | Nicole Marie Guza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548926462 PECOS PAC ID: 7012367980 Enrollment ID: I20231219002757 |
| Provider Name | Eric Wiszczur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235560152 PECOS PAC ID: 8729438536 Enrollment ID: I20231220000429 |
| Provider Name | Teresa Visoso-rangel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295168177 PECOS PAC ID: 4284084021 Enrollment ID: I20231220001657 |
| Provider Name | Joanne Kathrine Vanderveen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891914743 PECOS PAC ID: 3274983994 Enrollment ID: I20231221000864 |
| Provider Name | Wendy E Baty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114526456 PECOS PAC ID: 4082064704 Enrollment ID: I20231221000903 |
| Provider Name | Jennifer Prantera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508350323 PECOS PAC ID: 8729438338 Enrollment ID: I20231222000702 |
| Provider Name | Rhonda Lee Kozumplik |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699034306 PECOS PAC ID: 8729438346 Enrollment ID: I20231222001208 |
| Provider Name | Lee L Lapham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972941383 PECOS PAC ID: 4284084732 Enrollment ID: I20231222003025 |
| Provider Name | Michele Lynn Sweeney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609376938 PECOS PAC ID: 3173973633 Enrollment ID: I20231222003126 |
| Provider Name | John Frederick Daley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457924904 PECOS PAC ID: 8224488739 Enrollment ID: I20231226000978 |
| Provider Name | Nicol Grishkevich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578115549 PECOS PAC ID: 5597116368 Enrollment ID: I20240105000643 |
| Provider Name | Monica Crawford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083958235 PECOS PAC ID: 1355792144 Enrollment ID: I20240105001271 |
| Provider Name | Markita Mccutchen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790077816 PECOS PAC ID: 6305298613 Enrollment ID: I20240122003949 |
| Provider Name | Dorothy Jane Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386088961 PECOS PAC ID: 4284087495 Enrollment ID: I20240124001326 |
| Provider Name | Steve Lucas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114659372 PECOS PAC ID: 0042663163 Enrollment ID: I20240125000687 |
| Provider Name | Stephanie Lynn Kushel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184853434 PECOS PAC ID: 6204289242 Enrollment ID: I20240126000267 |
| Provider Name | Laura Casey-aydt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003954025 PECOS PAC ID: 8224481767 Enrollment ID: I20240131002490 |
| Provider Name | Lauree L Quada |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093965980 PECOS PAC ID: 7911340070 Enrollment ID: I20240206003580 |
| Provider Name | Kimberly Rodway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265989552 PECOS PAC ID: 0648613000 Enrollment ID: I20240213002283 |
| Provider Name | Jennifer Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184386708 PECOS PAC ID: 3971947243 Enrollment ID: I20240215000772 |
| Provider Name | Robert Timothy Gregory |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1366011934 PECOS PAC ID: 4082058805 Enrollment ID: I20240221000306 |
| Provider Name | Sherry L Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932293289 PECOS PAC ID: 4284078908 Enrollment ID: I20240221000537 |
| Provider Name | Lauren Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205697620 PECOS PAC ID: 1850735507 Enrollment ID: I20240221001441 |
| Provider Name | Earlene Wilhelm Blevins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669505806 PECOS PAC ID: 1355785015 Enrollment ID: I20240221001622 |
| Provider Name | Kaye Sanders |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285276733 PECOS PAC ID: 6103260815 Enrollment ID: I20240221003444 |
| Provider Name | Cynthia Williams-hurt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356879472 PECOS PAC ID: 8426493461 Enrollment ID: I20240229000251 |
| Provider Name | Cynthia Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497032643 PECOS PAC ID: 3072958735 Enrollment ID: I20240304003044 |
| Provider Name | Terri Ratliff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235872888 PECOS PAC ID: 4082050539 Enrollment ID: I20240307000798 |
| Provider Name | Julianne Alston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346617727 PECOS PAC ID: 5193161529 Enrollment ID: I20240307003862 |
| Provider Name | Donna Robin Weinstein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114418795 PECOS PAC ID: 0143666578 Enrollment ID: I20240307004054 |
| Provider Name | Tracy Dunton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447387550 PECOS PAC ID: 6608213335 Enrollment ID: I20240318001773 |
| Provider Name | Stephanie Shelton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699902163 PECOS PAC ID: 1153769435 Enrollment ID: I20240405000325 |
| Provider Name | Artemis Stanisz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093346587 PECOS PAC ID: 9931547981 Enrollment ID: I20240409004858 |
| Provider Name | Sara Elizabeth Schwartz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427711761 PECOS PAC ID: 3173962867 Enrollment ID: I20240415000700 |
| Provider Name | Jennifer Lynn Kent-bryant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427816826 PECOS PAC ID: 1759721731 Enrollment ID: I20240425000540 |
| Provider Name | Celia Kamps |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376790097 PECOS PAC ID: 4284808866 Enrollment ID: I20240425003648 |
| Provider Name | Sabreen K Ettaher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750954079 PECOS PAC ID: 3476993130 Enrollment ID: I20240429000317 |
| Provider Name | Sara Paige Dionne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376997569 PECOS PAC ID: 4587004734 Enrollment ID: I20240504000089 |
| Provider Name | Joseph Stewart Martinez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285396226 PECOS PAC ID: 7012358864 Enrollment ID: I20240511000201 |
| Provider Name | Diana Nael Varughese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922773514 PECOS PAC ID: 3779924980 Enrollment ID: I20240517002625 |
| Provider Name | Daina Leigh Sutton Mcadams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467901090 PECOS PAC ID: 5991147944 Enrollment ID: I20240522003981 |
| Provider Name | Vanessa Pacheco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538737150 PECOS PAC ID: 1254773997 Enrollment ID: I20240524003071 |
| Provider Name | Jason Rydzewski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689267262 PECOS PAC ID: 5496297095 Enrollment ID: I20240611002610 |
| Provider Name | Sarah Barsuhn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992467708 PECOS PAC ID: 4981146347 Enrollment ID: I20240613000324 |
| Provider Name | Annie Mccarthy Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114708898 PECOS PAC ID: 8628510013 Enrollment ID: I20240613001228 |
| Provider Name | Sara Rietsch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265828917 PECOS PAC ID: 5395288658 Enrollment ID: I20240614003891 |
Clarity Counseling Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6300 Sashabaw Rd Ste B, Clarkston, MI 48346 Phone: 517-202-2427 | |
12th Avenue Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5541 Warbler Dr, Clarkston, MI 48346 Phone: 248-795-5253 Fax: 248-928-5350 | |
Life Solutions Coaching Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8040 Ortonville Rd, Clarkston, MI 48348 Phone: 248-707-9477 | |
Milestones Aba Clinic Of Michigan Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5125 Indianwood Dr, Clarkston, MI 48348 Phone: 248-983-4828 Fax: 248-983-4839 | |
Kindmind Psychiatric Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5980 S Main St Ste 101, Clarkston, MI 48346 Phone: 248-470-7359 | |
Michigan Healthcare Professionals, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5625 Water Tower Pl Ste 310, Clarkston, MI 48346 Phone: 248-384-8130 | |
Convo Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10167 Graham Drive, Clarkston, MI 48348 Phone: 248-805-1764 |