| Lifespan Behavioral Health Services Pc | |
|
7474 Greenway Center Dr Ste 700a Greenbelt MD 20770-3523 | |
| (301) 982-3437 | |
| Not Available |
| Full Name | Lifespan Behavioral Health Services Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7474 Greenway Center Dr Ste 700a, Greenbelt, Maryland |
| Authorized Official Name and Position | Carolyn Reidy (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 8455903230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Behavioral Health Services Pc 2705 Silver Hammer Way Brookeville MD 20833-3244 Ph: () - | Lifespan Behavioral Health Services Pc 7474 Greenway Center Dr Ste 700a Greenbelt MD 20770-3523 Ph: (301) 982-3437 |
| NPI Number | 1881233872 |
|---|---|
| Provider Enumeration Date | 12/23/2019 |
| Last Update Date | 12/23/2019 |
| Certification Date | 12/23/2019 |
| Medicare PECOS PAC ID | 4082041637 |
|---|---|
| Medicare Enrollment ID | O20200221000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881233872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Joshua B Sussal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922212174 PECOS PAC ID: 6204936446 Enrollment ID: I20070717000335 |
| Provider Name | Amy D Hedderman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689953994 PECOS PAC ID: 1759680028 Enrollment ID: I20160509001604 |
| Provider Name | Geoffrey G Grammer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528141017 PECOS PAC ID: 8426375825 Enrollment ID: I20161202000253 |
| Provider Name | Nicholas S Kopp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720097132 PECOS PAC ID: 2961762604 Enrollment ID: I20180129001069 |
| Provider Name | Stephen E Simon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174722102 PECOS PAC ID: 5496015000 Enrollment ID: I20180130001787 |
| Provider Name | Larry S Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881620789 PECOS PAC ID: 3476526260 Enrollment ID: I20180222002989 |
| Provider Name | Olatunji Folawewo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710473087 PECOS PAC ID: 5991053258 Enrollment ID: I20180816000030 |
| Provider Name | Anna Gabriszeski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417544727 PECOS PAC ID: 9133536618 Enrollment ID: I20210513001595 |
| Provider Name | John Dahunsi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386378735 PECOS PAC ID: 3779951900 Enrollment ID: I20221205000632 |
| Provider Name | Akherenwei Gwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447670732 PECOS PAC ID: 6204150394 Enrollment ID: I20230731001700 |
| Provider Name | Amy Zawatsky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316284755 PECOS PAC ID: 8820445422 Enrollment ID: I20231121003497 |
| Provider Name | Christina L Poff-long |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851828826 PECOS PAC ID: 5597113233 Enrollment ID: I20231129002545 |
| Provider Name | Wendy Yowell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679515910 PECOS PAC ID: 4486004058 Enrollment ID: I20231221003403 |
| Provider Name | Delaney Rubenstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497339592 PECOS PAC ID: 0446601090 Enrollment ID: I20240108003946 |
| Provider Name | Linda Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871520627 PECOS PAC ID: 9638526122 Enrollment ID: I20240108004793 |
| Provider Name | Isabelle Hope Rohloff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013615830 PECOS PAC ID: 6608228556 Enrollment ID: I20240117000855 |
| Provider Name | Christopher Wheatley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063969806 PECOS PAC ID: 8628353851 Enrollment ID: I20240207004371 |
| Provider Name | Laura E Teeple |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427667294 PECOS PAC ID: 5294170247 Enrollment ID: I20240229000815 |
| Provider Name | Danielle Audley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659961688 PECOS PAC ID: 0244680353 Enrollment ID: I20240229001396 |
| Provider Name | Christine Woodcock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790437150 PECOS PAC ID: 6608214739 Enrollment ID: I20240409001164 |
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