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2550 S Telegraph Rd Ste 250 Bloomfield Hills MI 48302-0909 | |
| (248) 322-0001 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 2550 S Telegraph Rd Ste 250, Bloomfield Hills, Michigan |
| Authorized Official Name and Position | Leslie Johnson (CEO) |
| Authorized Official Contact | 7045066267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (248) 322-0001 | 2550 S Telegraph Rd Ste 250 Bloomfield Hills MI 48302-0909 Ph: (248) 322-0001 |
| NPI Number | 1851161285 |
|---|---|
| Provider Enumeration Date | 01/05/2024 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Medicare PECOS PAC ID | 0941648463 |
|---|---|
| Medicare Enrollment ID | O20240423001699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851161285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nikhil K Vora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043244411 PECOS PAC ID: 1052209079 Enrollment ID: I20040310000177 |
| Provider Name | Shuja Haque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427167378 PECOS PAC ID: 9335039817 Enrollment ID: I20040318000230 |
| Provider Name | Cheri H Dickinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972693604 PECOS PAC ID: 2860382397 Enrollment ID: I20040318000543 |
| Provider Name | Nancy H Wrobel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255427282 PECOS PAC ID: 7911990155 Enrollment ID: I20040405001222 |
| Provider Name | William L Guy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295748101 PECOS PAC ID: 3870581861 Enrollment ID: I20040506000688 |
| Provider Name | Peter N Mason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245322924 PECOS PAC ID: 0345290391 Enrollment ID: I20050127000086 |
| Provider Name | Diana J Diesch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518053560 PECOS PAC ID: 7517993835 Enrollment ID: I20050708000658 |
| Provider Name | Bettie Stokes Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497794002 PECOS PAC ID: 9931114899 Enrollment ID: I20060214000215 |
| Provider Name | Laurie D Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619071081 PECOS PAC ID: 8123033768 Enrollment ID: I20060217000433 |
| Provider Name | Debra K Gorney-jankowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932117009 PECOS PAC ID: 8527068477 Enrollment ID: I20061228000185 |
| Provider Name | Talia K Al-hamando |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033203161 PECOS PAC ID: 0941399554 Enrollment ID: I20071205000160 |
| Provider Name | Olimpia Neagoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063573418 PECOS PAC ID: 8426137100 Enrollment ID: I20080506000745 |
| Provider Name | Veronica Williams Latnie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689725210 PECOS PAC ID: 0446301956 Enrollment ID: I20090623000676 |
| Provider Name | Shobha Prasad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528132230 PECOS PAC ID: 6800925454 Enrollment ID: I20100520000452 |
| Provider Name | Elaine C Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902062615 PECOS PAC ID: 5496949208 Enrollment ID: I20101104001401 |
| Provider Name | Jimmica D Donald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124252713 PECOS PAC ID: 0840461133 Enrollment ID: I20110916000397 |
| Provider Name | Lashone M Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063787729 PECOS PAC ID: 1153551205 Enrollment ID: I20140311001194 |
| Provider Name | Eileen A Gallagher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699175679 PECOS PAC ID: 1254552987 Enrollment ID: I20141022002236 |
| Provider Name | Michael Kubiak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720257074 PECOS PAC ID: 8123341468 Enrollment ID: I20141217002824 |
| Provider Name | Dion P Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386702272 PECOS PAC ID: 2769705979 Enrollment ID: I20141219000569 |
| Provider Name | Theresa W Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720527146 PECOS PAC ID: 1052695152 Enrollment ID: I20170309002424 |
| Provider Name | Kenyatta Bates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205108404 PECOS PAC ID: 0547537904 Enrollment ID: I20170606002750 |
| Provider Name | Nicolette Cheff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740772193 PECOS PAC ID: 3971850827 Enrollment ID: I20180724000222 |
| Provider Name | Gina Nicole Shuster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497093348 PECOS PAC ID: 0446583710 Enrollment ID: I20190603000034 |
| Provider Name | Michael Charles Anton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104346402 PECOS PAC ID: 3274863790 Enrollment ID: I20190926001646 |
| Provider Name | Spencer M Mister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235618166 PECOS PAC ID: 9032453790 Enrollment ID: I20191009002357 |
| Provider Name | Sherry Lynn Mcclelland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154675205 PECOS PAC ID: 3375941057 Enrollment ID: I20211011001291 |
| Provider Name | Thomas A Sammon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033860614 PECOS PAC ID: 0143612408 Enrollment ID: I20220118001211 |
| Provider Name | Ashley Dione Milton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144687401 PECOS PAC ID: 5890177141 Enrollment ID: I20220802003766 |
| Provider Name | Jerome Roberson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306073713 PECOS PAC ID: 7214381342 Enrollment ID: I20231003001133 |
| Provider Name | Kimberly Keisel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285784736 PECOS PAC ID: 7911355375 Enrollment ID: I20231122002564 |
| Provider Name | Rema Mourad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194433003 PECOS PAC ID: 9133577562 Enrollment ID: I20231127000528 |
| Provider Name | Lori Ann Mello |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124699939 PECOS PAC ID: 0648628073 Enrollment ID: I20231127000697 |
| Provider Name | Kyle Powell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376639500 PECOS PAC ID: 4789032004 Enrollment ID: I20231128000882 |
| Provider Name | Vanita Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740756949 PECOS PAC ID: 2466801550 Enrollment ID: I20231214002579 |
| Provider Name | Darlene White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194364885 PECOS PAC ID: 2769834118 Enrollment ID: I20240122001558 |
| Provider Name | Mahla Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720033566 PECOS PAC ID: 5193168276 Enrollment ID: I20240206000848 |
| Provider Name | Patrick Cavell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225176712 PECOS PAC ID: 4981047461 Enrollment ID: I20240212003753 |
| Provider Name | Rachel Valentine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538253836 PECOS PAC ID: 5496199721 Enrollment ID: I20240214003791 |
| Provider Name | David William Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801878202 PECOS PAC ID: 8022454255 Enrollment ID: I20240311002703 |
| Provider Name | Patricia Pillars |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982822565 PECOS PAC ID: 6901341866 Enrollment ID: I20240716000389 |
| Provider Name | Donya Sorensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003359530 PECOS PAC ID: 5799223988 Enrollment ID: I20240820000253 |
Bloomfield Neurology Clinic, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 43494 Woodward Ave, Suite 103, Bloomfield Hills, MI 48302 Phone: 248-338-8400 Fax: 248-338-8151 | |
Neurodiagnostic & Sleep Disorder Center Nsd Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2525 S Telegraph Rd Ste 200, Bloomfield Hills, MI 48302 Phone: 248-451-1466 Fax: 248-451-1467 | |
Seymour Baxter M.d., Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 456 Lone Pine Ct, Bloomfield Hills, MI 48304 Phone: 248-642-4820 | |
Janie Bishop Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 549 Kingsley Trl, Bloomfield Hills, MI 48304 Phone: 248-709-5455 | |
Bharat Tolia Md Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2550 Telegraph Road, Suite 235, Bloomfield Hills, MI 48302 Phone: 248-334-0115 Fax: 248-334-3338 | |
Laura Espinosa Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 39520 Woodward Ave, Suite 215, Bloomfield Hills, MI 48304 Phone: 248-925-2250 | |
Mind Connections, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 41000 Woodward Ave Ste 350, Bloomfield Hills, MI 48304 Phone: 248-835-5705 Fax: 248-590-2867 |