| Centra Wellness Network | |
|
2198 Us 31 S Manistee MI 49660-9618 | |
| (877) 398-2013 | |
| Not Available |
| Full Name | Centra Wellness Network |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2198 Us 31 S, Manistee, Michigan |
| Authorized Official Name and Position | Donna Nieman (FINANCIAL OFFICER) |
| Authorized Official Contact | 8773982013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centra Wellness Network 310 Glocheski Dr Manistee MI 49660-2639 Ph: (877) 398-2013 | Centra Wellness Network 2198 Us 31 S Manistee MI 49660-9618 Ph: (877) 398-2013 |
| NPI Number | 1063581205 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 07/22/2022 |
| Certification Date | 07/22/2022 |
| Medicare PECOS PAC ID | 1850385329 |
|---|---|
| Medicare Enrollment ID | O20040408001362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063581205 | NPI | - | NPPES |
| 1705304 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Michigan) | Primary |
| Provider Name | Joseph L Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689737629 PECOS PAC ID: 4688778137 Enrollment ID: I20070322000560 |
| Provider Name | Gail L Mccormick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134193204 PECOS PAC ID: 8123188653 Enrollment ID: I20081113000617 |
| Provider Name | Jennifer Palamara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194738468 PECOS PAC ID: 2365531035 Enrollment ID: I20110104000496 |
| Provider Name | William F Ramsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922277052 PECOS PAC ID: 0345563300 Enrollment ID: I20141223001029 |
| Provider Name | Jean C Talsma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144660200 PECOS PAC ID: 0840583639 Enrollment ID: I20160802000442 |
| Provider Name | James Barczewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265185474 PECOS PAC ID: 3173762713 Enrollment ID: I20220609000485 |
| Provider Name | Connie M Brem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831746742 PECOS PAC ID: 3274907233 Enrollment ID: I20230315001215 |
Edward J. Loftus Ma Llp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Filer St Ste 210g, Manistee, MI 49660 Phone: 231-398-0349 | |
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