| Munster Behavioral Health, Inc | |
|
706 Ridge Rd Ste B Munster IN 46321-1612 | |
| (219) 356-2240 | |
| Not Available |
| Full Name | Munster Behavioral Health, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 706 Ridge Rd Ste B, Munster, Indiana |
| Authorized Official Name and Position | Emily Djorovic (OFFICE MANAGER) |
| Authorized Official Contact | 2193562240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Munster Behavioral Health, Inc 706 Ridge Rd Ste B Munster IN 46321-1612 Ph: (219) 356-2240 | Munster Behavioral Health, Inc 706 Ridge Rd Ste B Munster IN 46321-1612 Ph: (219) 356-2240 |
| NPI Number | 1295330736 |
|---|---|
| Provider Enumeration Date | 12/02/2020 |
| Last Update Date | 12/03/2020 |
| Certification Date | 12/03/2020 |
| Medicare PECOS PAC ID | 5395113732 |
|---|---|
| Medicare Enrollment ID | O20221116001638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295330736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Meladie A Langham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154633550 PECOS PAC ID: 7810397353 Enrollment ID: I20210621001544 |
| Provider Name | Michael Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457932337 PECOS PAC ID: 5890194401 Enrollment ID: I20220919000980 |
| Provider Name | Juan-estefan Vitela |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366899130 PECOS PAC ID: 9931577459 Enrollment ID: I20221115000413 |
| Provider Name | Jacqueline Liszewski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548816333 PECOS PAC ID: 2163873001 Enrollment ID: I20240104004278 |
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