| Northshore Psychological Associates, Llc | |
|
120 E 2nd St Third Floor Erie PA 16507-1537 | |
| (814) 877-8013 | |
| (814) 877-8007 |
| Full Name | Northshore Psychological Associates, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 120 E 2nd St, Erie, Pennsylvania |
| Authorized Official Name and Position | Michael Schwabenbauer (PARTNER) |
| Authorized Official Contact | 8148778013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Psychological Associates, Llc 120 E 2nd St Third Floor Erie PA 16507-1537 Ph: (814) 877-8013 | Northshore Psychological Associates, Llc 120 E 2nd St Third Floor Erie PA 16507-1537 Ph: (814) 877-8013 |
| NPI Number | 1891786331 |
|---|---|
| Provider Enumeration Date | 11/03/2005 |
| Last Update Date | 02/12/2015 |
| Medicare PECOS PAC ID | 0244133981 |
|---|---|
| Medicare Enrollment ID | O20040129000783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891786331 | NPI | - | NPPES |
| 0019240150003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Michael P Schwabenbauer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821093386 PECOS PAC ID: 1456254192 Enrollment ID: I20040130000020 |
| Provider Name | Mark Hogue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659377182 PECOS PAC ID: 0749173755 Enrollment ID: I20040204000428 |
| Provider Name | Donald Mcaleer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407851975 PECOS PAC ID: 0840183877 Enrollment ID: I20040204000540 |
| Provider Name | Tammy Lynn Kordes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932175171 PECOS PAC ID: 0648289132 Enrollment ID: I20060411000519 |
| Provider Name | Debra Thaler Gilroy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578586186 PECOS PAC ID: 4981607363 Enrollment ID: I20060825000160 |
| Provider Name | Elizabeth Marie Stroup |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972584480 PECOS PAC ID: 0042217408 Enrollment ID: I20061026000453 |
| Provider Name | Robert Lawrence Mailliard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487852935 PECOS PAC ID: 2769573286 Enrollment ID: I20070911000083 |
| Provider Name | Kristen Curry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659510782 PECOS PAC ID: 0143387399 Enrollment ID: I20090316000450 |
| Provider Name | Jon Glass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366727356 PECOS PAC ID: 7315113545 Enrollment ID: I20120110000286 |
| Provider Name | Jacqueline Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770670689 PECOS PAC ID: 3779686035 Enrollment ID: I20160317000195 |
| Provider Name | Susan Troutner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053861856 PECOS PAC ID: 4688954548 Enrollment ID: I20161212000236 |
| Provider Name | Alyssa A Mineo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588281976 PECOS PAC ID: 2668897398 Enrollment ID: I20200729000331 |
| Provider Name | Nykole Marie Gonzalez-mestres |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386314847 PECOS PAC ID: 5597162925 Enrollment ID: I20210927003136 |
| Provider Name | Krystal G Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881927986 PECOS PAC ID: 6204233646 Enrollment ID: I20210928000153 |
| Provider Name | Renee Dematteis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770294217 PECOS PAC ID: 5698146447 Enrollment ID: I20230114000081 |
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