| Physician Alliance For Mental Health, Llc | |
|
3208 Oleander Drive Wilmington NC 28403-0800 | |
| (910) 794-3929 | |
| (910) 798-2303 |
| Full Name | Physician Alliance For Mental Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3208 Oleander Drive, Wilmington, North Carolina |
| Authorized Official Name and Position | Wendy Rene Kaczynski (PROVIDER MANAGER) |
| Authorized Official Contact | 9102627107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Alliance For Mental Health, Llc Po Box 15511 Wilmington NC 28408-5511 Ph: (910) 794-3929 | Physician Alliance For Mental Health, Llc 3208 Oleander Drive Wilmington NC 28403-0800 Ph: (910) 794-3929 |
| NPI Number | 1285882928 |
|---|---|
| Provider Enumeration Date | 09/06/2008 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 1254461965 |
|---|---|
| Medicare Enrollment ID | O20100607000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285882928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christopher R Myers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003905670 PECOS PAC ID: 2365498466 Enrollment ID: I20050322000790 |
| Provider Name | Brett A Gurkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053355719 PECOS PAC ID: 7214953686 Enrollment ID: I20051015000126 |
| Provider Name | Pamela J Wenning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902021769 PECOS PAC ID: 1850472531 Enrollment ID: I20110303000529 |
| Provider Name | Katherine Sharon Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871861831 PECOS PAC ID: 6406078344 Enrollment ID: I20141110001826 |
| Provider Name | Patricia Davis Prichard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790217156 PECOS PAC ID: 3678834082 Enrollment ID: I20180228000034 |
| Provider Name | Amanda Lynn Spytkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285237677 PECOS PAC ID: 9537563580 Enrollment ID: I20210812001858 |
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