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3865 S Mackinac Trl Sault Sainte Marie MI 49783-9286 | |
| (906) 632-2805 | |
| (906) 632-1163 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3865 S Mackinac Trl, Sault Sainte Marie, Michigan |
| Authorized Official Name and Position | Samuel Harma (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9063412144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
125 N Lake St Manistique MI 49854-1234 Ph: (906) 341-2144 | 3865 S Mackinac Trl Sault Sainte Marie MI 49783-9286 Ph: (906) 632-2805 |
| NPI Number | 1629161567 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 11/16/2011 |
| Medicare PECOS PAC ID | 3870509490 |
|---|---|
| Medicare Enrollment ID | O20060306000454 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629161567 | NPI | - | NPPES |
| 7509104110 | Other | MI | BCBS |
| 774361332 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | David Meeker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336123520 PECOS PAC ID: 2264414770 Enrollment ID: I20040607000832 |
| Provider Name | Courtney E Grant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275771065 PECOS PAC ID: 3476605791 Enrollment ID: I20090717000349 |
| Provider Name | Lisa Tatrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053624635 PECOS PAC ID: 2163610817 Enrollment ID: I20101221001018 |
| Provider Name | Maria L Baller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467752386 PECOS PAC ID: 5496907461 Enrollment ID: I20121221000039 |
| Provider Name | Kerri L Hotlen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770925646 PECOS PAC ID: 2860714417 Enrollment ID: I20141210000047 |
| Provider Name | Jennifer Cifelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952735979 PECOS PAC ID: 7517276595 Enrollment ID: I20151013001427 |
| Provider Name | Marija Petrovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225138530 PECOS PAC ID: 9739281700 Enrollment ID: I20170214002631 |
| Provider Name | Goldie Lynn Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194275289 PECOS PAC ID: 6305183807 Enrollment ID: I20190122002326 |
| Provider Name | Holly Engle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659821775 PECOS PAC ID: 8123369147 Enrollment ID: I20190401000893 |
| Provider Name | Debra Joyce Peake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316306590 PECOS PAC ID: 8022341064 Enrollment ID: I20190606002260 |
| Provider Name | Blaine Janette Yoder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154908556 PECOS PAC ID: 3072960624 Enrollment ID: I20231103002247 |
| Provider Name | Debra Thurman Dobbs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134458029 PECOS PAC ID: 8921451626 Enrollment ID: I20240130000785 |
| Provider Name | David Nathaniel Frank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992226450 PECOS PAC ID: 8123471687 Enrollment ID: I20240131003332 |
| Provider Name | Lori Rachelle Metcalf-rodes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386168854 PECOS PAC ID: 9537504766 Enrollment ID: I20240228000684 |
| Provider Name | Stephanie Nicole Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922422898 PECOS PAC ID: 7618318338 Enrollment ID: I20240513002867 |
| Provider Name | Kelsey A Philliips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457929325 PECOS PAC ID: 5799127387 Enrollment ID: I20240529000171 |
| Provider Name | Cera Hudson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447985635 PECOS PAC ID: 4880134394 Enrollment ID: I20240911002136 |
| Provider Name | Lindsey Jo Cronin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922490176 PECOS PAC ID: 0042746133 Enrollment ID: I20241212002464 |
Northern Neurology, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 Osborn Blvd, Sault Sainte Marie, MI 49783 Phone: 906-253-9136 | |
Great Lakes Recovery Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1416 W Easterday Ave, Sault Sainte Marie, MI 49783 Phone: 906-748-9010 Fax: 906-553-6029 | |
Great Lakes Recovery Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 E Spruce St, Sault Sainte Marie, MI 49783 Phone: 906-259-9511 Fax: 906-553-6029 | |
U.p. Stress Center Psychological Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 545 Ashmun St, Suite 7, Sault Sainte Marie, MI 49783 Phone: 906-632-3001 Fax: 906-632-3015 | |
A Therapy World Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Ashmun St, Sault Sainte Marie, MI 49783 Phone: 906-632-2273 Fax: 906-632-7732 | |
Northern Transitions, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 W Easterday Ave, Sault Sainte Marie, MI 49783 Phone: 906-635-5681 Fax: 906-635-9615 |