Kent/sussex Community Mental Health Center | |
805 River Rd Dover DE 19901-3753 | |
(302) 739-4275 | |
Not Available |
Full Name | Kent/sussex Community Mental Health Center |
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Speciality | Clinic/Center |
Location | 805 River Rd, Dover, Delaware |
Authorized Official Name and Position | Stanley J Kotula (MEDICAL DIRECTOR/DIRECTOR OF CLINIC) |
Authorized Official Contact | 3025766093 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kent/sussex Community Mental Health Center 10 Sw Front St Milford DE 19963-1948 Ph: (302) 422-1422 | Kent/sussex Community Mental Health Center 805 River Rd Dover DE 19901-3753 Ph: (302) 739-4275 |
NPI Number | 1104871920 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 02/25/2020 |
Certification Date | 02/25/2020 |
Medicare PECOS PAC ID | 6507756731 |
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Medicare Enrollment ID | O20040319000575 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104871920 | NPI | - | NPPES |
0000609824 | Medicaid | DE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Duane D Shubert |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1639128465 PECOS PAC ID: 0446140354 Enrollment ID: I20040316000938 |
Provider Name | Rick Hong |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1851379473 PECOS PAC ID: 2961471461 Enrollment ID: I20040930001074 |
Provider Name | Andrew W Donohue |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1346237559 PECOS PAC ID: 2567434269 Enrollment ID: I20060223000123 |
Provider Name | Fawzia K Hasan |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1467506915 PECOS PAC ID: 3274639802 Enrollment ID: I20070427000463 |
Provider Name | Eric W Schwarz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053398461 PECOS PAC ID: 2163500042 Enrollment ID: I20080417000108 |
Provider Name | Stephen J Kushner |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134104805 PECOS PAC ID: 1355438037 Enrollment ID: I20080516000119 |
Provider Name | Mohammad Haque |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063424539 PECOS PAC ID: 8224111448 Enrollment ID: I20131127000186 |
Provider Name | Reinette N Charles |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518365360 PECOS PAC ID: 8022339225 Enrollment ID: I20150529002256 |
Provider Name | Curtis Harris |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033134234 PECOS PAC ID: 9335103928 Enrollment ID: I20161026003000 |
Provider Name | Vedette Bond |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326635194 PECOS PAC ID: 0941607261 Enrollment ID: I20210929000020 |
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