| Ph Social Workers /providence Hosptial And Medical Centers Inc | |
|
16001 W 9 Mile Rd Southfield MI 48075-4818 | |
| (248) 849-3000 | |
| (248) 849-2244 |
| Full Name | Ph Social Workers /providence Hosptial And Medical Centers Inc |
|---|---|
| Speciality | Social Worker |
| Location | 16001 W 9 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Sarah Starkel (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2486808121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ph Social Workers /providence Hosptial And Medical Centers Inc 3168 Solutions Ctr Chicago IL 60677-3001 Ph: (248) 680-8000 | Ph Social Workers /providence Hosptial And Medical Centers Inc 16001 W 9 Mile Rd Southfield MI 48075-4818 Ph: (248) 849-3000 |
| NPI Number | 1144285107 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 6103738703 |
|---|---|
| Medicare Enrollment ID | O20040316001258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144285107 | NPI | - | NPPES |
| 800F316780 | Other | MI | MI BLUE CROSS GROUPPIN# |
| Provider Name | Sharon L Paul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598780223 PECOS PAC ID: 6002893401 Enrollment ID: I20040702000846 |
| Provider Name | Lester E Potempa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164422283 PECOS PAC ID: 6608917760 Enrollment ID: I20100112000089 |
| Provider Name | Paula J Wells-primer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255323077 PECOS PAC ID: 3971783648 Enrollment ID: I20110212000072 |
| Provider Name | Tanya Woodards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609098813 PECOS PAC ID: 4284878414 Enrollment ID: I20130910000240 |
| Provider Name | Cynthia A Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417361361 PECOS PAC ID: 9739305210 Enrollment ID: I20140717002360 |
| Provider Name | Mallory Mcdonough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144569559 PECOS PAC ID: 9830417245 Enrollment ID: I20150415001691 |
| Provider Name | Mohammad Hanif |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114976503 PECOS PAC ID: 6002842804 Enrollment ID: I20160511000091 |
| Provider Name | Carmela Wilder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740723659 PECOS PAC ID: 5294005336 Enrollment ID: I20170721001132 |
| Provider Name | Marianne D Garascia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760915698 PECOS PAC ID: 2860763505 Enrollment ID: I20170731000397 |
| Provider Name | Jessica L Wentworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336591973 PECOS PAC ID: 9931471877 Enrollment ID: I20170828000871 |
| Provider Name | Mark M Bahoura |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790046191 PECOS PAC ID: 9032357041 Enrollment ID: I20171206000074 |
| Provider Name | Angela L Clauson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104312248 PECOS PAC ID: 7012268113 Enrollment ID: I20181001000488 |
| Provider Name | Yousef Maaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629432786 PECOS PAC ID: 5799055422 Enrollment ID: I20200429001888 |
| Provider Name | Ashley Hagerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063012359 PECOS PAC ID: 3971977968 Enrollment ID: I20230314001538 |
| Provider Name | Gary Francis Bess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326190372 PECOS PAC ID: 9335513936 Enrollment ID: I20230322001916 |
| Provider Name | Catherine Croft |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164958286 PECOS PAC ID: 3072956960 Enrollment ID: I20240207003480 |
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Christina L Shoemaker Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 29540 Southfield Rd Ste 101, Southfield, MI 48076 Phone: 248-506-3399 | |
Ascension Providence Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 16001 W. 9 Mile Road, Southfield, MI 48075 Phone: 243-349-3000 Fax: 248-746-0384 | |
Dahlia Berkovitz Phd Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 29623 Northwestern Hwy Lowr Level, Southfield, MI 48034 Phone: 248-760-8550 | |
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