| Indian Rivers Mhc | |
|
2209 9th St Tuscaloosa AL 35401-2300 | |
| (205) 391-3131 | |
| (205) 391-3137 |
| Full Name | Indian Rivers Mhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2209 9th St, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Blake Thrasher (CFO) |
| Authorized Official Contact | 2053913131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Rivers Mhc Po Box 2190 2209 9th Street Tuscaloosa AL 35403-2190 Ph: (205) 391-3131 | Indian Rivers Mhc 2209 9th St Tuscaloosa AL 35401-2300 Ph: (205) 391-3131 |
| NPI Number | 1659313393 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 01/23/2012 |
| Medicare PECOS PAC ID | 6608861638 |
|---|---|
| Medicare Enrollment ID | O20040419000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659313393 | NPI | - | NPPES |
| 330000024 | Medicaid | AL | |
| 330034024 | Medicaid | AL | |
| 528700510 | Medicaid | AL | |
| 590000024 | Medicaid | AL | |
| 51008111 | Other | AL | BCBS OF AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Alabama) | Primary |
| Provider Name | Jean F. Pointon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538276290 PECOS PAC ID: 8729071824 Enrollment ID: I20040407000717 |
| Provider Name | Syed R Aftab |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639119894 PECOS PAC ID: 9133192909 Enrollment ID: I20040818001362 |
| Provider Name | Antonowsky D Coleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063529485 PECOS PAC ID: 2860454626 Enrollment ID: I20041103000473 |
| Provider Name | Mahija Mungara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245454487 PECOS PAC ID: 1951315381 Enrollment ID: I20080206000411 |
| Provider Name | Mia M Galioto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225011307 PECOS PAC ID: 8527963560 Enrollment ID: I20080324000276 |
| Provider Name | Andrea Megan Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225183767 PECOS PAC ID: 1254373178 Enrollment ID: I20080820000451 |
| Provider Name | Hermine B Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063456960 PECOS PAC ID: 8325109853 Enrollment ID: I20081203000097 |
| Provider Name | Amee A Kozlovski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013243773 PECOS PAC ID: 4880736800 Enrollment ID: I20100202000616 |
| Provider Name | Andree G Stoves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871513382 PECOS PAC ID: 0749305688 Enrollment ID: I20100915000433 |
| Provider Name | Julie L Vansice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568554582 PECOS PAC ID: 0648284166 Enrollment ID: I20140214000692 |
| Provider Name | Tristan T Tave |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538539010 PECOS PAC ID: 7719261155 Enrollment ID: I20170301002500 |
| Provider Name | Leticia Mccrary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861931255 PECOS PAC ID: 1355618323 Enrollment ID: I20170522002721 |
| Provider Name | Molly E Dwyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972047199 PECOS PAC ID: 2668746306 Enrollment ID: I20170920000281 |
| Provider Name | Rhonda Snow Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326306358 PECOS PAC ID: 2668624958 Enrollment ID: I20190824000641 |
| Provider Name | Michelle L Serig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528538469 PECOS PAC ID: 7810228921 Enrollment ID: I20191003001809 |
| Provider Name | Latonia Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093349136 PECOS PAC ID: 3375963390 Enrollment ID: I20201013002446 |
| Provider Name | James John Reeves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992777155 PECOS PAC ID: 0840437430 Enrollment ID: I20201014002312 |
| Provider Name | Krystal Patrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558997247 PECOS PAC ID: 2365836111 Enrollment ID: I20220301000945 |
| Provider Name | Xinyi Ge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497314116 PECOS PAC ID: 4183006414 Enrollment ID: I20220803003097 |
| Provider Name | Katie F Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942909155 PECOS PAC ID: 7214301746 Enrollment ID: I20230323000394 |
| Provider Name | Cierra Silver Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851908768 PECOS PAC ID: 7416314810 Enrollment ID: I20230530002568 |
| Provider Name | Dana Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568169860 PECOS PAC ID: 3173971504 Enrollment ID: I20231127000780 |
| Provider Name | Michael D Wiggins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417280256 PECOS PAC ID: 5799136404 Enrollment ID: I20240108000400 |
| Provider Name | Victoria Winningham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194359083 PECOS PAC ID: 3274984992 Enrollment ID: I20240108000699 |
| Provider Name | Kimberly Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043090285 PECOS PAC ID: 5799138186 Enrollment ID: I20240201002645 |
| Provider Name | Sam Franklin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902442940 PECOS PAC ID: 5698171551 Enrollment ID: I20240205004321 |
| Provider Name | Rosalyn Dudley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033743927 PECOS PAC ID: 2961845417 Enrollment ID: I20240212002691 |
Viatru Life Solutions, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3915 Palisades Dr Ste B, Tuscaloosa, AL 35405 Phone: 833-484-2878 | |
Fresh Outlook Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 35 Cumberland Park, Tuscaloosa, AL 35404 Phone: 205-393-1319 | |
Crimson Counseling And Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2303 13th St, Tuscaloosa, AL 35401 Phone: 205-737-4675 | |
Allie C. Boyd, Md, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Fairfax Park, Tuscaloosa, AL 35406 Phone: 205-759-3229 Fax: 205-759-4151 | |
Brewer Porch Childre's Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Woodland Rd, Tuscaloosa, AL 35404 Phone: 205-348-7236 Fax: 205-348-9368 | |
Brewer Porch Children's Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Woodland Rd, Tuscaloosa, AL 35404 Phone: 205-348-7236 | |
University Diagnostics Of Tuscaloosa, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 701 University Blvd E Ste 204, Tuscaloosa, AL 35401 Phone: 205-553-9171 Fax: 205-553-9127 |