| Lifestance Health | |
|
122 Gateway Blvd Ste C Mooresville NC 28117-5544 | |
| (704) 360-3637 | |
| Not Available |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 122 Gateway Blvd Ste C, Mooresville, North Carolina |
| Authorized Official Name and Position | Asheli Thompson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7043603637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health Po Box 4962 Mooresville NC 28117-4962 Ph: () - | Lifestance Health 122 Gateway Blvd Ste C Mooresville NC 28117-5544 Ph: (704) 360-3637 |
| NPI Number | 1447760871 |
|---|---|
| Provider Enumeration Date | 10/12/2017 |
| Last Update Date | 06/09/2022 |
| Certification Date | 06/09/2022 |
| Medicare PECOS PAC ID | 8022341494 |
|---|---|
| Medicare Enrollment ID | O20190618000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447760871 | NPI | - | NPPES |
| Provider Name | Sharyn Comeau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548293723 PECOS PAC ID: 8820064512 Enrollment ID: I20040903000372 |
| Provider Name | Chin-ho T Pak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386721470 PECOS PAC ID: 5991774150 Enrollment ID: I20040925000155 |
| Provider Name | Phyllis Armstead |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871659342 PECOS PAC ID: 1759451925 Enrollment ID: I20080530000015 |
| Provider Name | Byron K Strother |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174582563 PECOS PAC ID: 6608936042 Enrollment ID: I20081115000022 |
| Provider Name | Laura M Duskin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881643310 PECOS PAC ID: 5496737140 Enrollment ID: I20100628000217 |
| Provider Name | Susan Curtis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093776320 PECOS PAC ID: 6305864299 Enrollment ID: I20130910000688 |
| Provider Name | Jennifer Parker Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013245745 PECOS PAC ID: 0648497479 Enrollment ID: I20140818002778 |
| Provider Name | Quanita Q Small |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154660827 PECOS PAC ID: 0143543793 Enrollment ID: I20150106002265 |
| Provider Name | Catherine A Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619050713 PECOS PAC ID: 2567650815 Enrollment ID: I20151229001834 |
| Provider Name | Tremika R Woodley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699217208 PECOS PAC ID: 6507141876 Enrollment ID: I20170329000703 |
| Provider Name | Panagiotis Peter Panagakis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558563288 PECOS PAC ID: 5890067763 Enrollment ID: I20170828002623 |
| Provider Name | Samuel M Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306250949 PECOS PAC ID: 8921372137 Enrollment ID: I20170926002925 |
| Provider Name | Sue Ann Bingham Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013054105 PECOS PAC ID: 9931465069 Enrollment ID: I20171107000005 |
| Provider Name | Courtney S Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437401023 PECOS PAC ID: 0244597987 Enrollment ID: I20171205000994 |
| Provider Name | Heart Song Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528204179 PECOS PAC ID: 3971864133 Enrollment ID: I20180302002042 |
| Provider Name | Bret Allen Guidry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588634554 PECOS PAC ID: 5496018178 Enrollment ID: I20180410003241 |
| Provider Name | Mindi Marie Perry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306176599 PECOS PAC ID: 6800077835 Enrollment ID: I20180625000917 |
| Provider Name | Colleen Baldrige |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619464906 PECOS PAC ID: 0143576900 Enrollment ID: I20180709002871 |
| Provider Name | Anita L Morrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447605266 PECOS PAC ID: 4880941905 Enrollment ID: I20180720001399 |
| Provider Name | Nicole Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649684044 PECOS PAC ID: 6002240587 Enrollment ID: I20191217001841 |
| Provider Name | Robert Bruce Risavi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144530940 PECOS PAC ID: 4082048319 Enrollment ID: I20191219002151 |
| Provider Name | Kristina Claire Borus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487297636 PECOS PAC ID: 9537593108 Enrollment ID: I20200107003227 |
| Provider Name | Lachaya Mary Radcliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467918029 PECOS PAC ID: 0345675062 Enrollment ID: I20200127000610 |
| Provider Name | Catelyn Vanauken Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356977623 PECOS PAC ID: 6406286384 Enrollment ID: I20200416000950 |
| Provider Name | Caressa D Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356847347 PECOS PAC ID: 9638591159 Enrollment ID: I20200629002988 |
| Provider Name | Pamela Feuerstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639788953 PECOS PAC ID: 8527485796 Enrollment ID: I20200902001699 |
| Provider Name | Robert L Bauer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437165669 PECOS PAC ID: 3971536194 Enrollment ID: I20200910002842 |
| Provider Name | Kenya Windley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821483876 PECOS PAC ID: 3476963356 Enrollment ID: I20201104000719 |
| Provider Name | John Melbourne Mcgraw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043249386 PECOS PAC ID: 5597834507 Enrollment ID: I20201230001252 |
| Provider Name | Courtney Quiana Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144872524 PECOS PAC ID: 2860806411 Enrollment ID: I20210122001319 |
| Provider Name | Megan Elizabeth Belich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174175541 PECOS PAC ID: 0345659355 Enrollment ID: I20210504000837 |
| Provider Name | Sakina Alston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073107751 PECOS PAC ID: 2062811920 Enrollment ID: I20210525002997 |
| Provider Name | Pratima Dahal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144801374 PECOS PAC ID: 2163823410 Enrollment ID: I20210624002205 |
| Provider Name | Katherine S Laubach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881129484 PECOS PAC ID: 3678843224 Enrollment ID: I20210819002149 |
| Provider Name | Elizabeth Afriyie Owusu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104301142 PECOS PAC ID: 0547650632 Enrollment ID: I20211203001370 |
| Provider Name | Stacy Bechtel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154833051 PECOS PAC ID: 1658763685 Enrollment ID: I20220124002706 |
| Provider Name | Wayne Alan Alston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376805762 PECOS PAC ID: 2365834322 Enrollment ID: I20220125000737 |
| Provider Name | Robert A Cochran |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699288530 PECOS PAC ID: 4880088681 Enrollment ID: I20220221001347 |
| Provider Name | Taquita Shanee Milner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891355970 PECOS PAC ID: 2769876333 Enrollment ID: I20220224000579 |
| Provider Name | Clarissa Anita Elmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710523196 PECOS PAC ID: 3678967635 Enrollment ID: I20220308002276 |
| Provider Name | Melinda Padmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861860033 PECOS PAC ID: 2365839446 Enrollment ID: I20220419002013 |
| Provider Name | Patricia Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760009005 PECOS PAC ID: 0840619441 Enrollment ID: I20220727000545 |
| Provider Name | Ajith Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053983098 PECOS PAC ID: 6204218142 Enrollment ID: I20220809001432 |
| Provider Name | Nicholas Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649928698 PECOS PAC ID: 8325421241 Enrollment ID: I20220810001163 |
| Provider Name | Victoria A Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174268981 PECOS PAC ID: 8325421753 Enrollment ID: I20220818000814 |
| Provider Name | Claris Livingstone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992321962 PECOS PAC ID: 4688092661 Enrollment ID: I20220831003475 |
| Provider Name | Alexandra Judith Lagunas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215459524 PECOS PAC ID: 0244614790 Enrollment ID: I20220831003577 |
| Provider Name | Tiffany Lindsay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821769894 PECOS PAC ID: 6002290566 Enrollment ID: I20220831003865 |
| Provider Name | Robert Anthony Townsend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699317198 PECOS PAC ID: 6406232453 Enrollment ID: I20220929000339 |
| Provider Name | Kelly Lynn Callahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629794755 PECOS PAC ID: 8123496486 Enrollment ID: I20221118000080 |
| Provider Name | Lucy Seagraves Magda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952077224 PECOS PAC ID: 7315316478 Enrollment ID: I20221212001935 |
| Provider Name | Sierra S Stanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518529064 PECOS PAC ID: 0648649400 Enrollment ID: I20221217000217 |
| Provider Name | Amanda Serena Read |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033751896 PECOS PAC ID: 3072983469 Enrollment ID: I20221229000796 |
| Provider Name | Patricia Bryant-renfro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821605148 PECOS PAC ID: 7911377353 Enrollment ID: I20221230000349 |
| Provider Name | Melisa Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386388932 PECOS PAC ID: 5597136820 Enrollment ID: I20230125001436 |
| Provider Name | Joanna Wiseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124646237 PECOS PAC ID: 1850764754 Enrollment ID: I20230317000712 |
| Provider Name | Celena Shivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033828207 PECOS PAC ID: 1951551514 Enrollment ID: I20230329003271 |
| Provider Name | Lori F Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841593845 PECOS PAC ID: 5193190064 Enrollment ID: I20230406000348 |
| Provider Name | Diana Hunter-eldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346948478 PECOS PAC ID: 8729443056 Enrollment ID: I20230420001248 |
| Provider Name | Paige H Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841990850 PECOS PAC ID: 4082070610 Enrollment ID: I20230523003148 |
| Provider Name | Martha Eseh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194427872 PECOS PAC ID: 1456540079 Enrollment ID: I20230531003744 |
| Provider Name | Cortlin J Polo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831714369 PECOS PAC ID: 4688073562 Enrollment ID: I20230602001876 |
| Provider Name | Nevaid Luke Nyagwande |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336892801 PECOS PAC ID: 9032577325 Enrollment ID: I20230619001115 |
| Provider Name | Leslie Diane Stover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275098162 PECOS PAC ID: 5799143616 Enrollment ID: I20230623002462 |
| Provider Name | Tia Janee Glaspie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508562349 PECOS PAC ID: 1052765088 Enrollment ID: I20230926000239 |
| Provider Name | Mildred Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023091832 PECOS PAC ID: 7416301999 Enrollment ID: I20231003000262 |
| Provider Name | Laura Elaine Haynes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336822717 PECOS PAC ID: 7911354527 Enrollment ID: I20231103000137 |
| Provider Name | Kirk Dillon Mochrie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821647389 PECOS PAC ID: 7517315534 Enrollment ID: I20231130001997 |
| Provider Name | Jennifer Mengel Hundt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417516337 PECOS PAC ID: 3375992423 Enrollment ID: I20231214000660 |
| Provider Name | Ronsenia Truelish Lindsay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346778487 PECOS PAC ID: 9638529167 Enrollment ID: I20231227000203 |
| Provider Name | Kellie Marie Shuford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831666494 PECOS PAC ID: 1254781669 Enrollment ID: I20231228000047 |
| Provider Name | Chelsey Diane Mcrorie Bartholet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457600983 PECOS PAC ID: 8325498652 Enrollment ID: I20231228000897 |
| Provider Name | Ashley Elizabeth Bagwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972998938 PECOS PAC ID: 0244680478 Enrollment ID: I20231229000810 |
| Provider Name | Kimberly Lynn Childress |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043675275 PECOS PAC ID: 0941650139 Enrollment ID: I20231229002939 |
| Provider Name | Kristen Nash Bumgarner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689204307 PECOS PAC ID: 0648620849 Enrollment ID: I20240101000363 |
| Provider Name | Stephen Paul Mcalister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285979104 PECOS PAC ID: 5092166082 Enrollment ID: I20240103003568 |
| Provider Name | Anna D Gross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851881569 PECOS PAC ID: 2860843547 Enrollment ID: I20240106000531 |
| Provider Name | Andrea Weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780148908 PECOS PAC ID: 2062863798 Enrollment ID: I20240108003262 |
| Provider Name | Latisha Chambers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518670124 PECOS PAC ID: 1951752575 Enrollment ID: I20240109000266 |
| Provider Name | Melissa Morgan Cobbs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932494721 PECOS PAC ID: 0446601884 Enrollment ID: I20240110000447 |
| Provider Name | Colleen C Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497112213 PECOS PAC ID: 4688025026 Enrollment ID: I20240110000628 |
| Provider Name | Tiffany Corbett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942738968 PECOS PAC ID: 7618328097 Enrollment ID: I20240110002141 |
| Provider Name | Melissa Lynn Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669808101 PECOS PAC ID: 4385095504 Enrollment ID: I20240111002737 |
| Provider Name | Patricia Ruth Lytwyn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760977003 PECOS PAC ID: 7113378381 Enrollment ID: I20240111004408 |
| Provider Name | Larry Jones Dagenhart |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558989616 PECOS PAC ID: 9234580424 Enrollment ID: I20240112000103 |
| Provider Name | Meghann Goddard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073104212 PECOS PAC ID: 7810348000 Enrollment ID: I20240112000310 |
| Provider Name | Heather Lee Herrig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235511023 PECOS PAC ID: 3678924875 Enrollment ID: I20240112000519 |
| Provider Name | Helen Lynn Dula |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265956080 PECOS PAC ID: 3173974375 Enrollment ID: I20240112000660 |
| Provider Name | Stephanie L Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780187831 PECOS PAC ID: 7810349842 Enrollment ID: I20240116001294 |
| Provider Name | Jenna Sara Derderian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942951686 PECOS PAC ID: 5092167031 Enrollment ID: I20240116001659 |
| Provider Name | Asia Natashia Fairley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407257504 PECOS PAC ID: 5991157885 Enrollment ID: I20240116003404 |
| Provider Name | Katherine Ruth Dickerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780816603 PECOS PAC ID: 5698127413 Enrollment ID: I20240117003507 |
| Provider Name | Courtney B Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154894665 PECOS PAC ID: 0143672899 Enrollment ID: I20240117004745 |
| Provider Name | Daniel Harmon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932743457 PECOS PAC ID: 0941652697 Enrollment ID: I20240117004815 |
| Provider Name | Cynthia Patrice Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093269631 PECOS PAC ID: 6305298035 Enrollment ID: I20240118002444 |
| Provider Name | Rasha Hussein Mohamed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265878292 PECOS PAC ID: 8325490634 Enrollment ID: I20240122003834 |
| Provider Name | Brooke Lachance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639655566 PECOS PAC ID: 0648622969 Enrollment ID: I20240122004395 |
| Provider Name | Paul A Louis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407409691 PECOS PAC ID: 6608228937 Enrollment ID: I20240122004593 |
| Provider Name | Lily Angeliki Mudry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366755282 PECOS PAC ID: 6709238983 Enrollment ID: I20240124000403 |
| Provider Name | Shahin Dadfar Sabouri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225479835 PECOS PAC ID: 6204289432 Enrollment ID: I20240124001992 |
| Provider Name | Tracey D White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558873778 PECOS PAC ID: 7214380450 Enrollment ID: I20240124002316 |
| Provider Name | Michelle M Hawbaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710079629 PECOS PAC ID: 3375992878 Enrollment ID: I20240124003246 |
| Provider Name | Sarah Barkley Sullivan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730721002 PECOS PAC ID: 8820441835 Enrollment ID: I20240125003941 |
| Provider Name | Barbara Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376868653 PECOS PAC ID: 0143673178 Enrollment ID: I20240126000114 |
| Provider Name | Brianne Chauvigne Reedy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316442908 PECOS PAC ID: 3678926615 Enrollment ID: I20240126000222 |
| Provider Name | Alexis Brianna Lowe Surratt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538765839 PECOS PAC ID: 6204289069 Enrollment ID: I20240129000301 |
| Provider Name | Amy Mccarthy Sifford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982832986 PECOS PAC ID: 4183077951 Enrollment ID: I20240129000406 |
| Provider Name | Angela Robin Wyatt Wooten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386039428 PECOS PAC ID: 3072966878 Enrollment ID: I20240129001681 |
| Provider Name | Megan Ann Sullivan Slingerland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912426297 PECOS PAC ID: 6406209170 Enrollment ID: I20240130000038 |
| Provider Name | Mary Elizabeth Stanley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922526904 PECOS PAC ID: 1355794033 Enrollment ID: I20240130000263 |
| Provider Name | Jessica Ruiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346858578 PECOS PAC ID: 4587017272 Enrollment ID: I20240130000452 |
| Provider Name | Christopher Michael Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174100119 PECOS PAC ID: 6507219201 Enrollment ID: I20240130000958 |
| Provider Name | Audra Alexander Vann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699319202 PECOS PAC ID: 3678926276 Enrollment ID: I20240131000786 |
| Provider Name | Ashlyn Nicole Vinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225683881 PECOS PAC ID: 6507219052 Enrollment ID: I20240131002934 |
| Provider Name | Cecilia Smith Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366942559 PECOS PAC ID: 5193178697 Enrollment ID: I20240131004592 |
| Provider Name | Cindy W Lyman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346567567 PECOS PAC ID: 4688017155 Enrollment ID: I20240212003167 |
| Provider Name | Erik Carlson Weir |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154199354 PECOS PAC ID: 0244674265 Enrollment ID: I20240219000933 |
| Provider Name | Pamela Michele Mccraw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801169487 PECOS PAC ID: 7810331725 Enrollment ID: I20240220000623 |
| Provider Name | Kathleen J. Walsh Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184853939 PECOS PAC ID: 5890139687 Enrollment ID: I20240220003876 |
| Provider Name | Stephanie Michelle Mcgee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932709920 PECOS PAC ID: 2961846787 Enrollment ID: I20240221000061 |
| Provider Name | Christian Marshall Davidson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164840450 PECOS PAC ID: 0941646111 Enrollment ID: I20240311000636 |
| Provider Name | Dorothy Danielle Brooks |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942975826 PECOS PAC ID: 8426494501 Enrollment ID: I20240312000589 |
| Provider Name | Chaqueenia Yvette Livingston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023573508 PECOS PAC ID: 6800232851 Enrollment ID: I20240312003669 |
| Provider Name | Charity Elizabeth Mae Matlock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861956567 PECOS PAC ID: 5294171252 Enrollment ID: I20240312003968 |
| Provider Name | Clifford Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912173956 PECOS PAC ID: 9133565195 Enrollment ID: I20240312004162 |
| Provider Name | Elizabeth Deboe Vaughan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528557832 PECOS PAC ID: 3072952324 Enrollment ID: I20240418003379 |
| Provider Name | Janet Marie Cannon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225257405 PECOS PAC ID: 3678725959 Enrollment ID: I20240422001167 |
| Provider Name | Isis Reddick-umoja |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598875247 PECOS PAC ID: 0749614378 Enrollment ID: I20240423002387 |
| Provider Name | Michelle Lynn Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912205576 PECOS PAC ID: 9032395330 Enrollment ID: I20240429003331 |
| Provider Name | Esther N Nam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003110404 PECOS PAC ID: 3476993981 Enrollment ID: I20240501002263 |
| Provider Name | Frank Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811766959 PECOS PAC ID: 7618317140 Enrollment ID: I20240501002801 |
| Provider Name | Kalila Rose Abu-sharr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144860784 PECOS PAC ID: 2860834694 Enrollment ID: I20240524002357 |
| Provider Name | Elizabeth Anne Bilisoly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710585757 PECOS PAC ID: 5698218097 Enrollment ID: I20240613001896 |
| Provider Name | Christine Denaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316587504 PECOS PAC ID: 7315480779 Enrollment ID: I20240613004108 |
Wellness Psychiatry Group, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 249 Williamson Rd, Suite 102, Mooresville, NC 28117 Phone: 704-912-7037 | |
Psychiatric Services Of Lake Norman Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Joe V. Knox Ave, Suite 104, Mooresville, NC 28117 Phone: 704-663-6660 Fax: 704-663-5343 | |
Pinnacle Performance Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 816 Brawley School Rd Ste F1, Mooresville, NC 28117 Phone: 704-799-1270 Fax: 704-799-1271 | |
Kristin Leigh Matas Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 107 Kilson Dr Ste 202, Mooresville, NC 28117 Phone: 704-302-6974 | |
The Center At Lake Norman Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Joe Knox Ave Ste 100, Mooresville, NC 28117 Phone: 704-980-9234 Fax: 866-321-9367 | |
Wellhaven Pastoral Counseling & Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Kilson Dr., Suite 205, Mooresville, NC 28117 Phone: 704-799-0105 | |
Integrative Wellness Solutions Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 122 Gateway Blvd, Mooresville, NC 28117 Phone: 704-360-3637 |