| Mars Memory Health Network | |
|
219 Racine Dr Ste B Mars Memory Health Network Wilmington NC 28403-8828 | |
| (910) 791-6277 | |
| (910) 791-6226 |
| Full Name | Mars Memory Health Network |
|---|---|
| Speciality | Psychologist |
| Location | 219 Racine Dr Ste B, Wilmington, North Carolina |
| Authorized Official Name and Position | Len B Lecci (OWNER AND MANAGER) |
| Authorized Official Contact | 9109627262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mars Memory Health Network 219 Racine Dr Ste B Mars Memory Health Network Wilmington NC 28403-8828 Ph: (910) 791-6277 | Mars Memory Health Network 219 Racine Dr Ste B Mars Memory Health Network Wilmington NC 28403-8828 Ph: (910) 791-6277 |
| NPI Number | 1811976426 |
|---|---|
| Provider Enumeration Date | 01/11/2006 |
| Last Update Date | 09/26/2011 |
| Medicare PECOS PAC ID | 3476566324 |
|---|---|
| Medicare Enrollment ID | O20081103000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811976426 | NPI | - | NPPES |
| 017HY | Other | NC | BC BS FOR MARS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 3041 (North Carolina) | Primary |
| Provider Name | Len B Lecci |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194742858 PECOS PAC ID: 3971543885 Enrollment ID: I20050510001091 |
| Provider Name | Kimberly Adams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093875338 PECOS PAC ID: 8123008059 Enrollment ID: I20080514000369 |
| Provider Name | Barry M Skoblar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528229945 PECOS PAC ID: 1759454010 Enrollment ID: I20080718000573 |
| Provider Name | Ashton M Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295914356 PECOS PAC ID: 7012093297 Enrollment ID: I20081118000660 |
| Provider Name | Michelle Elena Stack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952671950 PECOS PAC ID: 6406007962 Enrollment ID: I20150324002419 |
| Provider Name | Michelle Lubomski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821527466 PECOS PAC ID: 5799055166 Enrollment ID: I20170717003720 |
| Provider Name | Susan Lynn Moschos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780053223 PECOS PAC ID: 7214359306 Enrollment ID: I20200618000875 |
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