| Lifestance Health | |
|
25101 Chagrin Blvd Ste 100 Beachwood OH 44122-5694 | |
| (216) 468-5000 | |
| (216) 456-8128 |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 25101 Chagrin Blvd Ste 100, Beachwood, Ohio |
| Authorized Official Name and Position | Ryan Pardo (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 4252798500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health 25101 Chagrin Blvd. Suite 100 Beachwood OH 44122-5694 Ph: (216) 831-6611 | Lifestance Health 25101 Chagrin Blvd Ste 100 Beachwood OH 44122-5694 Ph: (216) 468-5000 |
| NPI Number | 1811915713 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 01/04/2024 |
| Certification Date | 01/04/2024 |
| Medicare PECOS PAC ID | 0446243760 |
|---|---|
| Medicare Enrollment ID | O20040405000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811915713 | NPI | - | NPPES |
| Provider Name | Mary Varane Schaffer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679501563 PECOS PAC ID: 4385549765 Enrollment ID: I20031208000879 |
| Provider Name | Karal H Stern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275514952 PECOS PAC ID: 9133025216 Enrollment ID: I20031209001141 |
| Provider Name | Barbara J Henry |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1669561874 PECOS PAC ID: 5890697676 Enrollment ID: I20040122000653 |
| Provider Name | Anthony R Smartnick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366429425 PECOS PAC ID: 8729981972 Enrollment ID: I20040127000990 |
| Provider Name | Ellen H Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033199419 PECOS PAC ID: 8022911056 Enrollment ID: I20040128000772 |
| Provider Name | Cynthia J Richards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619917630 PECOS PAC ID: 9830084854 Enrollment ID: I20040218000888 |
| Provider Name | Lori R Solaro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043374143 PECOS PAC ID: 0143214890 Enrollment ID: I20040414000534 |
| Provider Name | Shari N Ridge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700849536 PECOS PAC ID: 3870489610 Enrollment ID: I20040428000511 |
| Provider Name | William H Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043274764 PECOS PAC ID: 0042200966 Enrollment ID: I20040513000940 |
| Provider Name | Diane H Eden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720052772 PECOS PAC ID: 1254227093 Enrollment ID: I20040513001070 |
| Provider Name | Louise J Gottlob |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104888569 PECOS PAC ID: 9739179680 Enrollment ID: I20040513001112 |
| Provider Name | Anne M Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871557769 PECOS PAC ID: 5496738122 Enrollment ID: I20040614000065 |
| Provider Name | Lucille Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497806814 PECOS PAC ID: 4183692718 Enrollment ID: I20040922000200 |
| Provider Name | James T Bukuts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518055813 PECOS PAC ID: 7719942051 Enrollment ID: I20041129000094 |
| Provider Name | Connie K Hirsh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245374891 PECOS PAC ID: 5496703936 Enrollment ID: I20050111000587 |
| Provider Name | David B Moss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962531897 PECOS PAC ID: 6103875216 Enrollment ID: I20050114000920 |
| Provider Name | Carol L O'connell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154407583 PECOS PAC ID: 3173573110 Enrollment ID: I20050126001194 |
| Provider Name | James S Srp |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1861406456 PECOS PAC ID: 4082665195 Enrollment ID: I20050207000416 |
| Provider Name | Philip J Fischer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700808771 PECOS PAC ID: 6507811874 Enrollment ID: I20050318000898 |
| Provider Name | Michael E Baskin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255989562 PECOS PAC ID: 8123065489 Enrollment ID: I20050408000678 |
| Provider Name | Karl Thomas Bachman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497701395 PECOS PAC ID: 7214965003 Enrollment ID: I20050802000997 |
| Provider Name | Victoria S Becker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437170867 PECOS PAC ID: 1153343850 Enrollment ID: I20051221001100 |
| Provider Name | Omar Elhaj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821103904 PECOS PAC ID: 0648289744 Enrollment ID: I20060418000713 |
| Provider Name | Barbara G Hofelich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265460042 PECOS PAC ID: 7012910383 Enrollment ID: I20060808000005 |
| Provider Name | Mary T Matias Akhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720006760 PECOS PAC ID: 0547265076 Enrollment ID: I20060915000390 |
| Provider Name | Dipika J Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316939937 PECOS PAC ID: 7416952403 Enrollment ID: I20060926000357 |
| Provider Name | Richard F Rakos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356350326 PECOS PAC ID: 1355348327 Enrollment ID: I20061106000028 |
| Provider Name | Michael Borack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568549913 PECOS PAC ID: 6800894494 Enrollment ID: I20061114000473 |
| Provider Name | William F Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346349198 PECOS PAC ID: 5294838355 Enrollment ID: I20070309000173 |
| Provider Name | Krista L Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821218447 PECOS PAC ID: 0941306021 Enrollment ID: I20070507000263 |
| Provider Name | Jayne M Malpede |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700842325 PECOS PAC ID: 2163494279 Enrollment ID: I20070508000149 |
| Provider Name | Linda Evelsizer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114133469 PECOS PAC ID: 1254431638 Enrollment ID: I20070713000747 |
| Provider Name | Brian K Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184676066 PECOS PAC ID: 8325021751 Enrollment ID: I20070813000064 |
| Provider Name | Christopher C James |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790996726 PECOS PAC ID: 1658464706 Enrollment ID: I20070905000394 |
| Provider Name | Eric M Layne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316164817 PECOS PAC ID: 9032206792 Enrollment ID: I20071029000344 |
| Provider Name | Judy Diane Levendula |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558547554 PECOS PAC ID: 8325123540 Enrollment ID: I20080312000552 |
| Provider Name | Peter Golden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588867626 PECOS PAC ID: 0749350882 Enrollment ID: I20080602000671 |
| Provider Name | Richard Rutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760659692 PECOS PAC ID: 9931279684 Enrollment ID: I20080606000299 |
| Provider Name | Sara C Newman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497953657 PECOS PAC ID: 2264505445 Enrollment ID: I20080722000033 |
| Provider Name | Jennifer Shoenfelt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659562965 PECOS PAC ID: 8729153820 Enrollment ID: I20080826000047 |
| Provider Name | Kathryn E Hendricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659521722 PECOS PAC ID: 9436210598 Enrollment ID: I20081208000227 |
| Provider Name | Diane M Browne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679737407 PECOS PAC ID: 0941367973 Enrollment ID: I20090428000073 |
| Provider Name | Marcia Hesselgrave |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922245240 PECOS PAC ID: 8022166594 Enrollment ID: I20090511000589 |
| Provider Name | Kurt W Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437272788 PECOS PAC ID: 0749330157 Enrollment ID: I20090605000209 |
| Provider Name | Bushra Haneef Qureishi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396969416 PECOS PAC ID: 9537251087 Enrollment ID: I20090608000449 |
| Provider Name | Lisa M Fernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275744575 PECOS PAC ID: 5597810556 Enrollment ID: I20090827000508 |
| Provider Name | Michele R Cash |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1851461701 PECOS PAC ID: 4082633474 Enrollment ID: I20091023000322 |
| Provider Name | Mary Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306958830 PECOS PAC ID: 9335138833 Enrollment ID: I20091027000095 |
| Provider Name | Karin M Palmer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497986962 PECOS PAC ID: 8527105097 Enrollment ID: I20091103000041 |
| Provider Name | Kamal-neil S Dass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013932102 PECOS PAC ID: 2567597115 Enrollment ID: I20100322000084 |
| Provider Name | Susan Mcclure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588851448 PECOS PAC ID: 4183752215 Enrollment ID: I20100512000091 |
| Provider Name | Vanilda R Reyes De Noyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497901466 PECOS PAC ID: 2567592215 Enrollment ID: I20100607000939 |
| Provider Name | Harold D Hornbeck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245417211 PECOS PAC ID: 6800927005 Enrollment ID: I20100702000459 |
| Provider Name | Adrienne Y Mccray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518003417 PECOS PAC ID: 4284759259 Enrollment ID: I20100914000735 |
| Provider Name | Cynthia L Tufarella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649584814 PECOS PAC ID: 1052500808 Enrollment ID: I20110107001100 |
| Provider Name | Michael Tichy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386838837 PECOS PAC ID: 1557540432 Enrollment ID: I20110125000022 |
| Provider Name | Lee Ann K Eakins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821281981 PECOS PAC ID: 4688855513 Enrollment ID: I20110224000465 |
| Provider Name | Glenn Byers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689982878 PECOS PAC ID: 4082897459 Enrollment ID: I20110322000681 |
| Provider Name | Rachel M Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366640617 PECOS PAC ID: 9436328044 Enrollment ID: I20110815000943 |
| Provider Name | Mark J Hawrylo Ii |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033190236 PECOS PAC ID: 9234302738 Enrollment ID: I20111028000142 |
| Provider Name | Ellen H Pietz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982646436 PECOS PAC ID: 1254599467 Enrollment ID: I20120220000568 |
| Provider Name | David S Kwon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740577055 PECOS PAC ID: 8224297304 Enrollment ID: I20120308000677 |
| Provider Name | Mallika Lavakumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194903104 PECOS PAC ID: 6608022520 Enrollment ID: I20120809000102 |
| Provider Name | Holly A Schweitzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023348265 PECOS PAC ID: 1355476235 Enrollment ID: I20130207000329 |
| Provider Name | Alice Palmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134467442 PECOS PAC ID: 8628217791 Enrollment ID: I20130620000653 |
| Provider Name | Kathleen Svala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669634630 PECOS PAC ID: 7214177807 Enrollment ID: I20130702000349 |
| Provider Name | Dawn Glowatz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053621334 PECOS PAC ID: 0547440646 Enrollment ID: I20130710000432 |
| Provider Name | Kevin Michael Nasky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558441766 PECOS PAC ID: 6103067848 Enrollment ID: I20130723000803 |
| Provider Name | Monica Halter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689941262 PECOS PAC ID: 4981845351 Enrollment ID: I20130726000645 |
| Provider Name | Anna K Dendy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396086617 PECOS PAC ID: 4486895745 Enrollment ID: I20130729000852 |
| Provider Name | Shira S Fass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992143416 PECOS PAC ID: 7113169798 Enrollment ID: I20130810000102 |
| Provider Name | Rebecca L Al-hamdani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407113442 PECOS PAC ID: 6406098813 Enrollment ID: I20130814001030 |
| Provider Name | Melissa Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649528399 PECOS PAC ID: 8325281074 Enrollment ID: I20130827000819 |
| Provider Name | Todd Christopher Newman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750675849 PECOS PAC ID: 3971747668 Enrollment ID: I20130919000305 |
| Provider Name | Nellie Krawczynski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952683120 PECOS PAC ID: 1557595196 Enrollment ID: I20131014001304 |
| Provider Name | Jeanette S Biermann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639504368 PECOS PAC ID: 5193950749 Enrollment ID: I20131106001818 |
| Provider Name | Christine A Carey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134562168 PECOS PAC ID: 2668608837 Enrollment ID: I20131118000244 |
| Provider Name | Adam H Roth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679810774 PECOS PAC ID: 6305075128 Enrollment ID: I20140127001164 |
| Provider Name | Melanie K Falls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548208150 PECOS PAC ID: 2860621349 Enrollment ID: I20140203000741 |
| Provider Name | Paula B Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568896124 PECOS PAC ID: 1951531888 Enrollment ID: I20140220000873 |
| Provider Name | Lorraine C Donner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952722407 PECOS PAC ID: 2668602400 Enrollment ID: I20140224000621 |
| Provider Name | Aimee Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487942181 PECOS PAC ID: 3779714324 Enrollment ID: I20140324001172 |
| Provider Name | Janet L Dutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972921609 PECOS PAC ID: 5890928097 Enrollment ID: I20140423001315 |
| Provider Name | Jeremy Carpenter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316192842 PECOS PAC ID: 7416170246 Enrollment ID: I20140523002228 |
| Provider Name | Ann L Faber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831305739 PECOS PAC ID: 9133342819 Enrollment ID: I20140527002029 |
| Provider Name | Kimberly A Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083053375 PECOS PAC ID: 0648497198 Enrollment ID: I20140807001001 |
| Provider Name | Jill Matusek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083998801 PECOS PAC ID: 3678791464 Enrollment ID: I20140819002407 |
| Provider Name | Pamela Nilsson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396058327 PECOS PAC ID: 4183844327 Enrollment ID: I20141009002245 |
| Provider Name | Anne Simkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720247620 PECOS PAC ID: 8224352091 Enrollment ID: I20150127001205 |
| Provider Name | Jacqueline Countryman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396802096 PECOS PAC ID: 4183681919 Enrollment ID: I20150203001795 |
| Provider Name | Meghan M Gossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356749998 PECOS PAC ID: 6800111097 Enrollment ID: I20150210002052 |
| Provider Name | Erika Taddie-osborn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285023812 PECOS PAC ID: 3072838903 Enrollment ID: I20150217000321 |
| Provider Name | Kristin Michelle Hilfer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497145445 PECOS PAC ID: 5698092138 Enrollment ID: I20150323001013 |
| Provider Name | Stephanie S Krznarich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538551734 PECOS PAC ID: 8820315823 Enrollment ID: I20150401001809 |
| Provider Name | Nicholas K Eilbeck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275852253 PECOS PAC ID: 4789903816 Enrollment ID: I20150512000907 |
| Provider Name | Brookana Bonezzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225462641 PECOS PAC ID: 7810219201 Enrollment ID: I20150522002395 |
| Provider Name | Joy Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518375062 PECOS PAC ID: 6709107386 Enrollment ID: I20150608002178 |
| Provider Name | Tara B Carr |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174569776 PECOS PAC ID: 1850612367 Enrollment ID: I20150609003115 |
| Provider Name | Kelly M Schneiders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447689575 PECOS PAC ID: 1658692017 Enrollment ID: I20150610001767 |
| Provider Name | Patti G Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730497330 PECOS PAC ID: 1456672799 Enrollment ID: I20150611001567 |
| Provider Name | Diane T Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659708428 PECOS PAC ID: 7315258555 Enrollment ID: I20150615002206 |
| Provider Name | Lacey Marie Kolb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295119360 PECOS PAC ID: 9931414208 Enrollment ID: I20150814014270 |
| Provider Name | Jessica L Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376959239 PECOS PAC ID: 5597071415 Enrollment ID: I20150908002105 |
| Provider Name | Sarah Elizabeth Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275909350 PECOS PAC ID: 7719293604 Enrollment ID: I20150909001336 |
| Provider Name | Beth E Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548670375 PECOS PAC ID: 2062729619 Enrollment ID: I20150915002613 |
| Provider Name | Esther B Gotfryd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508245218 PECOS PAC ID: 5092023093 Enrollment ID: I20150924000824 |
| Provider Name | Jamie Reed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588997811 PECOS PAC ID: 8325348303 Enrollment ID: I20151123002400 |
| Provider Name | Michelle Ferrant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689963399 PECOS PAC ID: 6204007891 Enrollment ID: I20160126000189 |
| Provider Name | Sandra M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194112227 PECOS PAC ID: 0941505663 Enrollment ID: I20160217002607 |
| Provider Name | Meghan M Parys |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871959494 PECOS PAC ID: 8123325156 Enrollment ID: I20160318000745 |
| Provider Name | Kimberly Hauser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093148587 PECOS PAC ID: 6800194374 Enrollment ID: I20160415002134 |
| Provider Name | Linda G Craft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033547492 PECOS PAC ID: 5395034359 Enrollment ID: I20160513000972 |
| Provider Name | Gary E Carrington |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164614103 PECOS PAC ID: 2163511015 Enrollment ID: I20160513001095 |
| Provider Name | Nicole Mccrackin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902273378 PECOS PAC ID: 9739470915 Enrollment ID: I20160617001183 |
| Provider Name | Lisa Dejarnette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326383647 PECOS PAC ID: 1254623820 Enrollment ID: I20160630001628 |
| Provider Name | Marsha W Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598934846 PECOS PAC ID: 0345319547 Enrollment ID: I20160714001394 |
| Provider Name | Cheryl F Barker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255780334 PECOS PAC ID: 3971897380 Enrollment ID: I20160808002776 |
| Provider Name | Gabriel Somarriba |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518375476 PECOS PAC ID: 8426343963 Enrollment ID: I20160823003027 |
| Provider Name | Christine E Billick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255783668 PECOS PAC ID: 7214222355 Enrollment ID: I20160829000624 |
| Provider Name | Mary Whitmyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952643660 PECOS PAC ID: 4789970682 Enrollment ID: I20160831003083 |
| Provider Name | Maryellen Smolenski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255673257 PECOS PAC ID: 7810283587 Enrollment ID: I20160906001558 |
| Provider Name | Debra A Santos |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1275553562 PECOS PAC ID: 6800981218 Enrollment ID: I20160929001959 |
| Provider Name | Mary Elizabeth Singeltary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437448032 PECOS PAC ID: 8628216322 Enrollment ID: I20161007000071 |
| Provider Name | Nicholas Alan Baston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740739366 PECOS PAC ID: 7214215276 Enrollment ID: I20161025002825 |
| Provider Name | Nicole Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063758217 PECOS PAC ID: 2961780556 Enrollment ID: I20161102001599 |
| Provider Name | Benjamin List |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780924746 PECOS PAC ID: 3870808025 Enrollment ID: I20161201001620 |
| Provider Name | Alenna Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649728155 PECOS PAC ID: 6103106489 Enrollment ID: I20161201002386 |
| Provider Name | Tanya P Morrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609173707 PECOS PAC ID: 4284914490 Enrollment ID: I20161205002465 |
| Provider Name | Sonal K Moratschek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871722546 PECOS PAC ID: 4486934528 Enrollment ID: I20161207002692 |
| Provider Name | Deanna Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134422645 PECOS PAC ID: 4082994835 Enrollment ID: I20161213001511 |
| Provider Name | Tracy Mcclorey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104273580 PECOS PAC ID: 0648550343 Enrollment ID: I20161215002276 |
| Provider Name | Diane Wendel Habel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649678434 PECOS PAC ID: 7517248503 Enrollment ID: I20170105002388 |
| Provider Name | Bethany T Kelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821439902 PECOS PAC ID: 1759663461 Enrollment ID: I20170112002003 |
| Provider Name | Allison M Mora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790220077 PECOS PAC ID: 8123301538 Enrollment ID: I20170209001008 |
| Provider Name | Anna Popova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699031708 PECOS PAC ID: 0446533855 Enrollment ID: I20170209001271 |
| Provider Name | Robert Ussai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679922017 PECOS PAC ID: 5597048504 Enrollment ID: I20170216000901 |
| Provider Name | Krystal Lynne Drake |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588918536 PECOS PAC ID: 4789821034 Enrollment ID: I20170323001378 |
| Provider Name | Laura Obert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154670883 PECOS PAC ID: 1951686328 Enrollment ID: I20170327001971 |
| Provider Name | Christopher Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710410444 PECOS PAC ID: 7911283296 Enrollment ID: I20170421001182 |
| Provider Name | Stephanie M Timmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194816934 PECOS PAC ID: 3577851625 Enrollment ID: I20170511002887 |
| Provider Name | Jasmine N Shafto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336177856 PECOS PAC ID: 1951678440 Enrollment ID: I20170605002459 |
| Provider Name | Allen D Mcconnell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639564032 PECOS PAC ID: 8729356068 Enrollment ID: I20170609001811 |
| Provider Name | Christopher Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710370606 PECOS PAC ID: 6800164427 Enrollment ID: I20170622000711 |
| Provider Name | Laura A Siarkowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700182227 PECOS PAC ID: 8123397163 Enrollment ID: I20170706001275 |
| Provider Name | Susan Rowland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528506748 PECOS PAC ID: 3173894482 Enrollment ID: I20170804001854 |
| Provider Name | Stacie Simons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245750777 PECOS PAC ID: 1557632734 Enrollment ID: I20170807001007 |
| Provider Name | Candice Sanborn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730502568 PECOS PAC ID: 4880966449 Enrollment ID: I20170817001411 |
| Provider Name | Kristen Schmauder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982019055 PECOS PAC ID: 0749552263 Enrollment ID: I20170817004191 |
| Provider Name | Lisa M Kehle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568516888 PECOS PAC ID: 8426021551 Enrollment ID: I20170905001731 |
| Provider Name | Christopher Darnell Lautt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538682174 PECOS PAC ID: 9739453457 Enrollment ID: I20170919003751 |
| Provider Name | James Elek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366740458 PECOS PAC ID: 0345515235 Enrollment ID: I20171003004770 |
| Provider Name | Kasandra Aussem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942660394 PECOS PAC ID: 5193091247 Enrollment ID: I20171018000772 |
| Provider Name | Amanda Lehner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821347881 PECOS PAC ID: 8022384668 Enrollment ID: I20171025003003 |
| Provider Name | Dauntrica Wallstrum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528580370 PECOS PAC ID: 4789940008 Enrollment ID: I20171102000456 |
| Provider Name | Scott Rohrbaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982113023 PECOS PAC ID: 5890051122 Enrollment ID: I20171102000847 |
| Provider Name | Sean Mccreary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568984540 PECOS PAC ID: 8628334455 Enrollment ID: I20171113000653 |
| Provider Name | Jeffrey Berman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548631617 PECOS PAC ID: 5294092532 Enrollment ID: I20171122000408 |
| Provider Name | Jane Ruthann Aridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225568553 PECOS PAC ID: 4082971940 Enrollment ID: I20171130001871 |
| Provider Name | Lacresha Rox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427386994 PECOS PAC ID: 0042579963 Enrollment ID: I20180122001255 |
| Provider Name | Elizabeth Beilstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245450816 PECOS PAC ID: 1355601097 Enrollment ID: I20180129000967 |
| Provider Name | Elizabeth Winner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790828846 PECOS PAC ID: 4486914074 Enrollment ID: I20180130000864 |
| Provider Name | Virginia Sidlo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831586478 PECOS PAC ID: 9234499740 Enrollment ID: I20180201000602 |
| Provider Name | Lauren Rosenberger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831635812 PECOS PAC ID: 3779843289 Enrollment ID: I20180201000633 |
| Provider Name | Meredith Elise Mahilo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881936102 PECOS PAC ID: 2365702248 Enrollment ID: I20180214002608 |
| Provider Name | Hayley Englander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750515813 PECOS PAC ID: 9830459627 Enrollment ID: I20180216001944 |
| Provider Name | Amy Lynn Ogden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154830131 PECOS PAC ID: 5597027359 Enrollment ID: I20180315001172 |
| Provider Name | Tina Steen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003339656 PECOS PAC ID: 8527321272 Enrollment ID: I20180411002487 |
| Provider Name | Patricia Sinclair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306176557 PECOS PAC ID: 4082977681 Enrollment ID: I20180412002258 |
| Provider Name | Elizabeth Armstrong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700902871 PECOS PAC ID: 5092933275 Enrollment ID: I20180419002454 |
| Provider Name | Jennifer R Mlady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689161002 PECOS PAC ID: 7315201001 Enrollment ID: I20180504000941 |
| Provider Name | Ujjwal P Ramtekkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871749523 PECOS PAC ID: 9133363831 Enrollment ID: I20180622000181 |
| Provider Name | Jenifer L Schutte |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316355845 PECOS PAC ID: 7012264195 Enrollment ID: I20180719003659 |
| Provider Name | Kara Jeanine Reilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235657420 PECOS PAC ID: 7416206313 Enrollment ID: I20180827002239 |
| Provider Name | Lindsey Slivka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982945812 PECOS PAC ID: 7719237270 Enrollment ID: I20180904000677 |
| Provider Name | Rebecca Manville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730696063 PECOS PAC ID: 9739430620 Enrollment ID: I20180914001542 |
| Provider Name | Elizabeth A Pfalzgraf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184105223 PECOS PAC ID: 7911259874 Enrollment ID: I20181004001777 |
| Provider Name | Sara Sungwoon Hong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437595923 PECOS PAC ID: 8325355696 Enrollment ID: I20181004001902 |
| Provider Name | Ildiko M Sherman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083146112 PECOS PAC ID: 9436401817 Enrollment ID: I20181012001243 |
| Provider Name | Kaitlyn Marie Mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043555329 PECOS PAC ID: 3779837794 Enrollment ID: I20181109002853 |
| Provider Name | Anne Marie C Minges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427337674 PECOS PAC ID: 8527377068 Enrollment ID: I20181128003023 |
| Provider Name | Danielle D Younge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649631664 PECOS PAC ID: 8820332083 Enrollment ID: I20181129001677 |
| Provider Name | Paul M Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861420358 PECOS PAC ID: 9931334166 Enrollment ID: I20181217002913 |
| Provider Name | Erica Marie Capretta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427432145 PECOS PAC ID: 9032454095 Enrollment ID: I20181219000942 |
| Provider Name | Michael R Difillipo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174774954 PECOS PAC ID: 2365635711 Enrollment ID: I20181219003518 |
| Provider Name | Mary Ann Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497279673 PECOS PAC ID: 9335485317 Enrollment ID: I20190111001851 |
| Provider Name | Trena Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619307832 PECOS PAC ID: 2264779560 Enrollment ID: I20190124001624 |
| Provider Name | Crystal Thomas-rozea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972762755 PECOS PAC ID: 3870830672 Enrollment ID: I20190201001475 |
| Provider Name | Stephanie R Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033498324 PECOS PAC ID: 8820380520 Enrollment ID: I20190228003072 |
| Provider Name | Amelia R Baffa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205319357 PECOS PAC ID: 5092055525 Enrollment ID: I20190320002278 |
| Provider Name | Elizabeth A Edington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144744426 PECOS PAC ID: 0840531935 Enrollment ID: I20190418002041 |
| Provider Name | Hannah Day Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316406226 PECOS PAC ID: 9234471558 Enrollment ID: I20190506002626 |
| Provider Name | Michael D Joyce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043772338 PECOS PAC ID: 7911240551 Enrollment ID: I20190522000973 |
| Provider Name | Amy Mattern |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275927139 PECOS PAC ID: 1052621984 Enrollment ID: I20190529001841 |
| Provider Name | Cherie A Shanko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093230419 PECOS PAC ID: 7517290877 Enrollment ID: I20190531002185 |
| Provider Name | Michele Marie Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679088025 PECOS PAC ID: 1052645470 Enrollment ID: I20190618003701 |
| Provider Name | Natalie M Grandy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982174702 PECOS PAC ID: 0446584601 Enrollment ID: I20190624000355 |
| Provider Name | Mary Canonico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811465594 PECOS PAC ID: 7517292980 Enrollment ID: I20190709000433 |
| Provider Name | Michael Mcfadden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881127728 PECOS PAC ID: 6901132034 Enrollment ID: I20190729000675 |
| Provider Name | Laura Basco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093375180 PECOS PAC ID: 6305172271 Enrollment ID: I20190730003286 |
| Provider Name | Lady-dreama Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952841850 PECOS PAC ID: 8820324791 Enrollment ID: I20190730003380 |
| Provider Name | Jennifer Marie Giesel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144628751 PECOS PAC ID: 1456688365 Enrollment ID: I20190814002825 |
| Provider Name | Richelle Sheets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821640699 PECOS PAC ID: 1658608500 Enrollment ID: I20190814003978 |
| Provider Name | Melanie Prepetit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891003588 PECOS PAC ID: 8921336686 Enrollment ID: I20190820002330 |
| Provider Name | Karen M Steffes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164081733 PECOS PAC ID: 6406184753 Enrollment ID: I20190823001605 |
| Provider Name | Ashley Hollins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689232118 PECOS PAC ID: 8325376254 Enrollment ID: I20190829003346 |
| Provider Name | Gayatriben Sameer Gadani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205069085 PECOS PAC ID: 6800029950 Enrollment ID: I20190909002560 |
| Provider Name | Joseph Fondriest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447783154 PECOS PAC ID: 2769711191 Enrollment ID: I20190911000722 |
| Provider Name | Kristin Circle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952959900 PECOS PAC ID: 7315277050 Enrollment ID: I20190924001095 |
| Provider Name | Kaitlyn Samantha Baker-wlodyka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750894721 PECOS PAC ID: 9537490149 Enrollment ID: I20191014000913 |
| Provider Name | Ramona Mahesh Bhatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376075085 PECOS PAC ID: 8123390846 Enrollment ID: I20191113001533 |
| Provider Name | Ryan Matthew Ware |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083112478 PECOS PAC ID: 7517390115 Enrollment ID: I20191212002537 |
| Provider Name | Frank Ezzo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841249505 PECOS PAC ID: 2163856402 Enrollment ID: I20191219002667 |
| Provider Name | Rachel Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154962769 PECOS PAC ID: 2668807876 Enrollment ID: I20200116001358 |
| Provider Name | Kaci N Willey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619493889 PECOS PAC ID: 5698103638 Enrollment ID: I20200325001431 |
| Provider Name | Julie Janco-gidley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780043554 PECOS PAC ID: 0840629572 Enrollment ID: I20200401001640 |
| Provider Name | William Lee Marcus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912412552 PECOS PAC ID: 2062842032 Enrollment ID: I20200415003521 |
| Provider Name | Ariel D Mintz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386030385 PECOS PAC ID: 8820396690 Enrollment ID: I20200609002853 |
| Provider Name | Danielle Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699332700 PECOS PAC ID: 6800218710 Enrollment ID: I20200623002153 |
| Provider Name | Andrew Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598209967 PECOS PAC ID: 8527482603 Enrollment ID: I20200724000639 |
| Provider Name | Lydia Lee Potoma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558908400 PECOS PAC ID: 6800212663 Enrollment ID: I20200811003933 |
| Provider Name | Annette Humberson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568007011 PECOS PAC ID: 4587080973 Enrollment ID: I20200817000797 |
| Provider Name | Angela Michelle Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679032163 PECOS PAC ID: 2860825833 Enrollment ID: I20200824000497 |
| Provider Name | James Howard Hinman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972632032 PECOS PAC ID: 0042637845 Enrollment ID: I20200825001836 |
| Provider Name | Justine Holthaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316412174 PECOS PAC ID: 3971920281 Enrollment ID: I20200901003026 |
| Provider Name | Aarin Kristin Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427520287 PECOS PAC ID: 8426476300 Enrollment ID: I20200909000624 |
| Provider Name | John Mallery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487707238 PECOS PAC ID: 4981791787 Enrollment ID: I20200910002730 |
| Provider Name | Denise Re |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215554050 PECOS PAC ID: 5496174559 Enrollment ID: I20200923002429 |
| Provider Name | Alexis Witte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073027686 PECOS PAC ID: 7113346156 Enrollment ID: I20200924002453 |
| Provider Name | Nimisha P Thuluvath |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669882890 PECOS PAC ID: 0244452894 Enrollment ID: I20201006003050 |
| Provider Name | Kyle Resnick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619331774 PECOS PAC ID: 7315367448 Enrollment ID: I20201012001518 |
| Provider Name | Kristin Emerling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518441385 PECOS PAC ID: 1456771468 Enrollment ID: I20201013001981 |
| Provider Name | Larissa Mehling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194194001 PECOS PAC ID: 6800206160 Enrollment ID: I20201028001127 |
| Provider Name | Michelle Linette Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972853968 PECOS PAC ID: 5193137115 Enrollment ID: I20201216002202 |
| Provider Name | Genaye Marie Ladousier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851598726 PECOS PAC ID: 7911310107 Enrollment ID: I20210107000958 |
| Provider Name | Sheila M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487250916 PECOS PAC ID: 6800209578 Enrollment ID: I20210120000244 |
| Provider Name | Charlotte A Steerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366048506 PECOS PAC ID: 1052725215 Enrollment ID: I20210128002984 |
| Provider Name | Rachel Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003421827 PECOS PAC ID: 8123432259 Enrollment ID: I20210201000168 |
| Provider Name | Samantha Rae Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336627355 PECOS PAC ID: 9133479488 Enrollment ID: I20210203001611 |
| Provider Name | Donna Moeller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922600725 PECOS PAC ID: 6103232848 Enrollment ID: I20210304001274 |
| Provider Name | Leslie Pulver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114454501 PECOS PAC ID: 0143636407 Enrollment ID: I20210310003205 |
| Provider Name | Kimberly T Cromer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063030765 PECOS PAC ID: 2264848589 Enrollment ID: I20210311002501 |
| Provider Name | Heather Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629508353 PECOS PAC ID: 8921414954 Enrollment ID: I20210316003068 |
| Provider Name | La'risha Jeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962911925 PECOS PAC ID: 2163839820 Enrollment ID: I20210324001324 |
| Provider Name | Faye Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154309508 PECOS PAC ID: 8921994427 Enrollment ID: I20210405001609 |
| Provider Name | Tiffany Seneff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346829959 PECOS PAC ID: 4981012960 Enrollment ID: I20210412000629 |
| Provider Name | Sherry D Greene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376069245 PECOS PAC ID: 8921416777 Enrollment ID: I20210416001093 |
| Provider Name | Morgan L Stitzlein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063869691 PECOS PAC ID: 9830508654 Enrollment ID: I20210507001163 |
| Provider Name | Michele Denise Fischer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265703250 PECOS PAC ID: 7416366075 Enrollment ID: I20210511002496 |
| Provider Name | Eric North |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649864810 PECOS PAC ID: 2567871056 Enrollment ID: I20210513001501 |
| Provider Name | Andrew Steven Kreger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710331194 PECOS PAC ID: 4183910615 Enrollment ID: I20210518000410 |
| Provider Name | Emily Nhu Cao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376997643 PECOS PAC ID: 1153720255 Enrollment ID: I20210521001465 |
| Provider Name | Tracy King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548878937 PECOS PAC ID: 5890194724 Enrollment ID: I20210526002594 |
| Provider Name | Jordan L Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316427818 PECOS PAC ID: 1658770086 Enrollment ID: I20210604000377 |
| Provider Name | Samantha Bellinger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164856639 PECOS PAC ID: 5294087177 Enrollment ID: I20210607003053 |
| Provider Name | Jenny Beitko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750976858 PECOS PAC ID: 1456751767 Enrollment ID: I20210608001952 |
| Provider Name | Jessica Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437736493 PECOS PAC ID: 0840690400 Enrollment ID: I20210618000398 |
| Provider Name | Tanisha Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881177392 PECOS PAC ID: 8921400409 Enrollment ID: I20210706003178 |
| Provider Name | April Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649795790 PECOS PAC ID: 7113320763 Enrollment ID: I20210720003858 |
| Provider Name | Lejeana M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821650193 PECOS PAC ID: 0345645818 Enrollment ID: I20210820002063 |
| Provider Name | Logan J Mcginty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821667643 PECOS PAC ID: 9032515028 Enrollment ID: I20210830002825 |
| Provider Name | Emily Nicole Broad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043725971 PECOS PAC ID: 2961808878 Enrollment ID: I20210901000601 |
| Provider Name | Tyneah Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184250755 PECOS PAC ID: 7416353354 Enrollment ID: I20210901001978 |
| Provider Name | Richard D Tuff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619590148 PECOS PAC ID: 1456757905 Enrollment ID: I20210908001966 |
| Provider Name | Xoliswa N Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043880313 PECOS PAC ID: 0042616344 Enrollment ID: I20210913001574 |
| Provider Name | Megan Grady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780108258 PECOS PAC ID: 4688085046 Enrollment ID: I20210916001148 |
| Provider Name | Michael E Spitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437283975 PECOS PAC ID: 9931506904 Enrollment ID: I20210920000741 |
| Provider Name | Jacquelyn Marie Mcdaniel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427300318 PECOS PAC ID: 2466859350 Enrollment ID: I20210920001751 |
| Provider Name | Lillie Raynice Quarles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083382469 PECOS PAC ID: 8820495641 Enrollment ID: I20210921003853 |
| Provider Name | Emily Jarvis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417254343 PECOS PAC ID: 8224436472 Enrollment ID: I20211001002376 |
| Provider Name | Nikki J Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821661547 PECOS PAC ID: 7315345030 Enrollment ID: I20211011003080 |
| Provider Name | James R Polzner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891018578 PECOS PAC ID: 0840425567 Enrollment ID: I20211027003358 |
| Provider Name | Lisa A Friend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902303902 PECOS PAC ID: 6608264346 Enrollment ID: I20211028001997 |
| Provider Name | Kelly Elizabeth Papenfus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972043099 PECOS PAC ID: 6800284308 Enrollment ID: I20211103001327 |
| Provider Name | Karen Renee Byerly-lamm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548522386 PECOS PAC ID: 4688062086 Enrollment ID: I20211103001580 |
| Provider Name | Shakele Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316614936 PECOS PAC ID: 9830588227 Enrollment ID: I20211104002282 |
| Provider Name | Jasmine Janis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740648443 PECOS PAC ID: 4880083617 Enrollment ID: I20211116001322 |
| Provider Name | Steven Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871258889 PECOS PAC ID: 1153711254 Enrollment ID: I20211203001953 |
| Provider Name | Jeffrey Iannone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164980934 PECOS PAC ID: 8921498908 Enrollment ID: I20211206002336 |
| Provider Name | Leighann R Karrip |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801464458 PECOS PAC ID: 0042600744 Enrollment ID: I20211213001965 |
| Provider Name | Jennifer Rose Holley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790451235 PECOS PAC ID: 6406247998 Enrollment ID: I20211216001394 |
| Provider Name | Daryn Van Hunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174282008 PECOS PAC ID: 5799176939 Enrollment ID: I20211227000409 |
| Provider Name | Tanya Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285300491 PECOS PAC ID: 5496146144 Enrollment ID: I20220106002214 |
| Provider Name | Maneesha Rose Verma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316433501 PECOS PAC ID: 3072907708 Enrollment ID: I20220223001688 |
| Provider Name | Jodi Marie Walters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578811055 PECOS PAC ID: 1355736331 Enrollment ID: I20220310001581 |
| Provider Name | Areum Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295189116 PECOS PAC ID: 5698062032 Enrollment ID: I20220311000349 |
| Provider Name | Mary Rooney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093710964 PECOS PAC ID: 6901067966 Enrollment ID: I20220322002861 |
| Provider Name | Danyel Heilman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750930319 PECOS PAC ID: 3072909555 Enrollment ID: I20220409000396 |
| Provider Name | Ian M Marconi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568128395 PECOS PAC ID: 8022404367 Enrollment ID: I20220413001328 |
| Provider Name | David Eugene Mcnair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861159782 PECOS PAC ID: 1759768054 Enrollment ID: I20220505002555 |
| Provider Name | Nicholas Stephen Rossy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104475649 PECOS PAC ID: 6002294741 Enrollment ID: I20220608000937 |
| Provider Name | Bonnie Runions |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063922326 PECOS PAC ID: 2062890569 Enrollment ID: I20220610001564 |
| Provider Name | Christopher M Sobecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114660818 PECOS PAC ID: 3577942010 Enrollment ID: I20220614000961 |
| Provider Name | Jeanette Michelle Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770854218 PECOS PAC ID: 1557740172 Enrollment ID: I20220628000520 |
| Provider Name | Leah Stallworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003138314 PECOS PAC ID: 4486034048 Enrollment ID: I20220629002242 |
| Provider Name | Danielle Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124560347 PECOS PAC ID: 7810370376 Enrollment ID: I20220816000978 |
| Provider Name | Matthew T Wick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548816689 PECOS PAC ID: 4789068636 Enrollment ID: I20220826001548 |
| Provider Name | Jenna Wade |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841762374 PECOS PAC ID: 5395129084 Enrollment ID: I20220830000833 |
| Provider Name | Ann Stromberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467844522 PECOS PAC ID: 9335467067 Enrollment ID: I20221019001149 |
| Provider Name | Victoria Lambrou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588214647 PECOS PAC ID: 0345618815 Enrollment ID: I20221115002356 |
| Provider Name | Anna M Cherri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912629114 PECOS PAC ID: 4284002007 Enrollment ID: I20221128002526 |
| Provider Name | Diane Durkin Petersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669514980 PECOS PAC ID: 4981073376 Enrollment ID: I20221206003225 |
| Provider Name | Tracy Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629685391 PECOS PAC ID: 2466822598 Enrollment ID: I20230105001270 |
| Provider Name | Erin Taggart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144704271 PECOS PAC ID: 2264802024 Enrollment ID: I20230112001181 |
| Provider Name | Hannah Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962875302 PECOS PAC ID: 9830560564 Enrollment ID: I20230117001830 |
| Provider Name | Brandy S Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437816576 PECOS PAC ID: 3375914807 Enrollment ID: I20230120001139 |
| Provider Name | Kayla Gehle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326778309 PECOS PAC ID: 2466823729 Enrollment ID: I20230124001452 |
| Provider Name | Morgan Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104477082 PECOS PAC ID: 1850762972 Enrollment ID: I20230126003032 |
| Provider Name | Calli Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770297087 PECOS PAC ID: 2264804111 Enrollment ID: I20230202002090 |
| Provider Name | Holly Marie Higgs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083325427 PECOS PAC ID: 2062884679 Enrollment ID: I20230208001284 |
| Provider Name | Gina M. Vaisberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851015424 PECOS PAC ID: 0941672463 Enrollment ID: I20230209002867 |
| Provider Name | Biaunka Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366826166 PECOS PAC ID: 1951774355 Enrollment ID: I20230306002395 |
| Provider Name | Kimberly Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508316258 PECOS PAC ID: 1052724259 Enrollment ID: I20230315000993 |
| Provider Name | Jason Kent Stofel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972961290 PECOS PAC ID: 6507230059 Enrollment ID: I20230323001356 |
| Provider Name | Katelyn Fox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467070292 PECOS PAC ID: 9537534714 Enrollment ID: I20230403000417 |
| Provider Name | Kelly A Conn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790236420 PECOS PAC ID: 8729453667 Enrollment ID: I20230407000464 |
| Provider Name | Jennifer Rose Seelie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124735683 PECOS PAC ID: 7810362605 Enrollment ID: I20230410000653 |
| Provider Name | Stephanie Ann Little |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265139901 PECOS PAC ID: 0840656245 Enrollment ID: I20230509002176 |
| Provider Name | James Andrew Gedra |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669176921 PECOS PAC ID: 2264823475 Enrollment ID: I20230602001664 |
| Provider Name | Navjoth Karuvannur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588161723 PECOS PAC ID: 2466819420 Enrollment ID: I20230606002702 |
| Provider Name | Cynthia K Cook-wion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720223464 PECOS PAC ID: 2466690045 Enrollment ID: I20230609000097 |
| Provider Name | Carly Hamaoui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043913015 PECOS PAC ID: 8729445390 Enrollment ID: I20230613002535 |
| Provider Name | Trista D Piccola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891005161 PECOS PAC ID: 4284092727 Enrollment ID: I20230615001716 |
| Provider Name | Michael S Hatesohl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427510510 PECOS PAC ID: 8325381189 Enrollment ID: I20230620001180 |
| Provider Name | Spencer Gerber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265011894 PECOS PAC ID: 6406215763 Enrollment ID: I20230705000544 |
| Provider Name | Billy Astudillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750961983 PECOS PAC ID: 3173982097 Enrollment ID: I20230710001941 |
| Provider Name | Khannah Keziah Wetmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629754122 PECOS PAC ID: 4183086101 Enrollment ID: I20230808002359 |
| Provider Name | Jessica A White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134502123 PECOS PAC ID: 0143682278 Enrollment ID: I20230821004069 |
| Provider Name | Laila Nicole Moussi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659871069 PECOS PAC ID: 8820452089 Enrollment ID: I20230907000650 |
| Provider Name | Genevieve J Sofranec |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124673967 PECOS PAC ID: 9133583859 Enrollment ID: I20230914000659 |
| Provider Name | Taylor Michael Fredrickson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932660818 PECOS PAC ID: 4183078637 Enrollment ID: I20231002003045 |
| Provider Name | Nan Wang Maclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073259669 PECOS PAC ID: 0941657514 Enrollment ID: I20231103002951 |
| Provider Name | Jillane E Holland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124314745 PECOS PAC ID: 7012366230 Enrollment ID: I20231213003734 |
| Provider Name | Lauren Kathleen O'brien |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336407873 PECOS PAC ID: 8325491889 Enrollment ID: I20240131003243 |
| Provider Name | Marina Bernard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700350550 PECOS PAC ID: 2264885771 Enrollment ID: I20240131005058 |
| Provider Name | Cassandra Lee Abbott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134358179 PECOS PAC ID: 1254774318 Enrollment ID: I20240206003359 |
| Provider Name | Kara Brooke Zepp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174041487 PECOS PAC ID: 7517300676 Enrollment ID: I20240206003395 |
| Provider Name | Kara Louise Leach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376984484 PECOS PAC ID: 4981047875 Enrollment ID: I20240207003482 |
| Provider Name | Christine Dessoffy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417489642 PECOS PAC ID: 2860835683 Enrollment ID: I20240208003226 |
| Provider Name | Jessica Brady Snow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912454166 PECOS PAC ID: 0143663971 Enrollment ID: I20240208003569 |
| Provider Name | Mona Breitbeil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407116775 PECOS PAC ID: 6002259512 Enrollment ID: I20240212001540 |
| Provider Name | Steven J Fratantonio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760725196 PECOS PAC ID: 4082057526 Enrollment ID: I20240212002241 |
| Provider Name | Stephanie Jan Durham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689160707 PECOS PAC ID: 0840633343 Enrollment ID: I20240212004267 |
| Provider Name | Erica M Allen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386959708 PECOS PAC ID: 0244674661 Enrollment ID: I20240213004797 |
| Provider Name | Lacey Caparanis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134622004 PECOS PAC ID: 6002250396 Enrollment ID: I20240214002747 |
| Provider Name | Robin Doolittle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275851131 PECOS PAC ID: 7618311341 Enrollment ID: I20240221000639 |
| Provider Name | Meredith Cowden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548610074 PECOS PAC ID: 5597109249 Enrollment ID: I20240221001468 |
| Provider Name | Derek James Dickson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174053052 PECOS PAC ID: 6800230566 Enrollment ID: I20240221001639 |
| Provider Name | Jonathan Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770988628 PECOS PAC ID: 4587008164 Enrollment ID: I20240222001629 |
| Provider Name | Nicole Louise Durbin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871094565 PECOS PAC ID: 0042654634 Enrollment ID: I20240222001991 |
| Provider Name | Brenda Wolfe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215169982 PECOS PAC ID: 6002250545 Enrollment ID: I20240222003894 |
| Provider Name | Javier Robledo Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689446213 PECOS PAC ID: 8325482888 Enrollment ID: I20240223000535 |
| Provider Name | Bonnie J Frye |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831165091 PECOS PAC ID: 0042654519 Enrollment ID: I20240223000643 |
| Provider Name | Aimee Elise Yeager |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306364583 PECOS PAC ID: 0941645493 Enrollment ID: I20240223003664 |
| Provider Name | Paula Sue Ignizio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659798007 PECOS PAC ID: 5395180848 Enrollment ID: I20240223003706 |
| Provider Name | Emily S. Plank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295067619 PECOS PAC ID: 2062857527 Enrollment ID: I20240224000166 |
| Provider Name | Ross A Fiorello |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588011811 PECOS PAC ID: 8426493743 Enrollment ID: I20240227001096 |
| Provider Name | Andrew Tarr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225557028 PECOS PAC ID: 2961847975 Enrollment ID: I20240229002577 |
| Provider Name | Ellen Gormley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841944501 PECOS PAC ID: 0446696934 Enrollment ID: I20240306003409 |
| Provider Name | Allison Rowlette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073050910 PECOS PAC ID: 7416339056 Enrollment ID: I20240307001579 |
| Provider Name | Sierra Ann-marie White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174097430 PECOS PAC ID: 7911343397 Enrollment ID: I20240307002077 |
| Provider Name | Sherri Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487148474 PECOS PAC ID: 6507202918 Enrollment ID: I20240307003244 |
| Provider Name | Meghan Elizabeth Kelsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235693664 PECOS PAC ID: 6608212030 Enrollment ID: I20240307004040 |
| Provider Name | Stephanie Rae Wells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073723094 PECOS PAC ID: 4981040177 Enrollment ID: I20240311001258 |
| Provider Name | Angela Grey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538445697 PECOS PAC ID: 8022454073 Enrollment ID: I20240312003857 |
| Provider Name | Rachel Green |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407228950 PECOS PAC ID: 0547606410 Enrollment ID: I20240313004037 |
| Provider Name | Brooklyn Hampton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255814992 PECOS PAC ID: 3971985623 Enrollment ID: I20240320002323 |
| Provider Name | Tiffany Dawn Hinkle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629421268 PECOS PAC ID: 4789021247 Enrollment ID: I20240320002485 |
| Provider Name | Danielle M Vancura |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790068260 PECOS PAC ID: 1254778400 Enrollment ID: I20240322002723 |
| Provider Name | Bridget Ann Lind |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326315227 PECOS PAC ID: 5991122038 Enrollment ID: I20240328001796 |
| Provider Name | Deborah M Klecha |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649497686 PECOS PAC ID: 5193162964 Enrollment ID: I20240328002237 |
| Provider Name | Catherine Kuzmishin Mast |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083398036 PECOS PAC ID: 8527406313 Enrollment ID: I20240328003185 |
| Provider Name | Shantel Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952751729 PECOS PAC ID: 6901244797 Enrollment ID: I20240328003577 |
| Provider Name | Margo Ann Smith-joseph |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598053266 PECOS PAC ID: 6800234675 Enrollment ID: I20240329002600 |
| Provider Name | Stephanie Rinaldi Flynn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134605306 PECOS PAC ID: 5991143018 Enrollment ID: I20240409000336 |
| Provider Name | Michael Patton Weatherford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194282137 PECOS PAC ID: 9739527888 Enrollment ID: I20240409001182 |
| Provider Name | Kaira Gramley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245751270 PECOS PAC ID: 9537507645 Enrollment ID: I20240409003402 |
| Provider Name | Laura Marie Palisin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538356423 PECOS PAC ID: 0547608564 Enrollment ID: I20240409003746 |
| Provider Name | David T Walters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275858326 PECOS PAC ID: 5799123766 Enrollment ID: I20240410000738 |
| Provider Name | Taylor Mcvay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073126728 PECOS PAC ID: 1951749936 Enrollment ID: I20240410000849 |
| Provider Name | Angela Weber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265948947 PECOS PAC ID: 4688012669 Enrollment ID: I20240410000854 |
| Provider Name | Clinton B Symons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427336999 PECOS PAC ID: 5294173290 Enrollment ID: I20240410001691 |
| Provider Name | Jena M Iacco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659847077 PECOS PAC ID: 0840638771 Enrollment ID: I20240410003240 |
| Provider Name | Valarie Mcknight |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174972905 PECOS PAC ID: 5092154906 Enrollment ID: I20240411002039 |
| Provider Name | Tiffany Lynn Drago |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356550917 PECOS PAC ID: 0547609380 Enrollment ID: I20240412003337 |
| Provider Name | Emily Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801346804 PECOS PAC ID: 9335588185 Enrollment ID: I20240412003944 |
| Provider Name | Jenna M Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578057048 PECOS PAC ID: 4880033547 Enrollment ID: I20240415003237 |
| Provider Name | Stacey Aiton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356717516 PECOS PAC ID: 9436598745 Enrollment ID: I20240419001301 |
| Provider Name | Carin Taylor Ives-clark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114446903 PECOS PAC ID: 7214376342 Enrollment ID: I20240422002212 |
| Provider Name | Jessica Lieberth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053654210 PECOS PAC ID: 5294174322 Enrollment ID: I20240422002321 |
| Provider Name | Cassidy Keller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427560465 PECOS PAC ID: 2264871300 Enrollment ID: I20240422002472 |
| Provider Name | Kimberly Ann Mclaughlin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225343080 PECOS PAC ID: 6406295542 Enrollment ID: I20240422002628 |
| Provider Name | Suzanne Hoskin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497175079 PECOS PAC ID: 8022457191 Enrollment ID: I20240423000140 |
| Provider Name | Rachel Michelle Lyons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205205085 PECOS PAC ID: 2961854286 Enrollment ID: I20240423001956 |
| Provider Name | Erika Britt Leibovitch |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871084079 PECOS PAC ID: 8325488034 Enrollment ID: I20240429002182 |
| Provider Name | Brenda S Pinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669921227 PECOS PAC ID: 4880034073 Enrollment ID: I20240506000614 |
| Provider Name | Debra Lynn Sherman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063430270 PECOS PAC ID: 3173964186 Enrollment ID: I20240508001917 |
| Provider Name | Nicole Marko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629563101 PECOS PAC ID: 5698116440 Enrollment ID: I20240511000099 |
| Provider Name | Jennifer Hudson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285073817 PECOS PAC ID: 5092156745 Enrollment ID: I20240513000187 |
| Provider Name | Vicky L Pomarico |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083055669 PECOS PAC ID: 2860833563 Enrollment ID: I20240513002086 |
| Provider Name | Emma Poduska |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437731296 PECOS PAC ID: 5496196123 Enrollment ID: I20240513003153 |
| Provider Name | Virginia Dawn Short |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174030084 PECOS PAC ID: 4587005103 Enrollment ID: I20240514003234 |
| Provider Name | Carolina Sanchez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093308959 PECOS PAC ID: 5597106070 Enrollment ID: I20240515001622 |
| Provider Name | Kara Freeman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861993057 PECOS PAC ID: 2668813908 Enrollment ID: I20240516004006 |
| Provider Name | Morgan Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689219636 PECOS PAC ID: 5991146110 Enrollment ID: I20240517002860 |
| Provider Name | Melinda Stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982139002 PECOS PAC ID: 2769823905 Enrollment ID: I20240518000094 |
| Provider Name | James C. Hodgins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669831962 PECOS PAC ID: 9739521931 Enrollment ID: I20240520002008 |
| Provider Name | Clayton Schmidt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942882683 PECOS PAC ID: 9830531060 Enrollment ID: I20240520002881 |
| Provider Name | Brady Austin Mertens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114305869 PECOS PAC ID: 5799127536 Enrollment ID: I20240524002681 |
| Provider Name | Desiree Paschal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891147179 PECOS PAC ID: 5294177036 Enrollment ID: I20240524002886 |
| Provider Name | Katelyn Marie Mcgookey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497285589 PECOS PAC ID: 8820430580 Enrollment ID: I20240525000096 |
| Provider Name | Kathryn M Roeding |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356636195 PECOS PAC ID: 8628410230 Enrollment ID: I20240529000816 |
| Provider Name | Joshua Minnich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235798968 PECOS PAC ID: 5597107946 Enrollment ID: I20240530002126 |
| Provider Name | Jennifer Murphy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114311602 PECOS PAC ID: 8628410933 Enrollment ID: I20240531000378 |
| Provider Name | Olivia Kathleen Perna |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619462462 PECOS PAC ID: 1254873540 Enrollment ID: I20240531003768 |
| Provider Name | Joseph Patrick Dunson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366677064 PECOS PAC ID: 0042752867 Enrollment ID: I20240607003389 |
| Provider Name | Craig Fitzgerald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396272241 PECOS PAC ID: 7618419359 Enrollment ID: I20240610000394 |
| Provider Name | Rachel Kay Mertens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023504255 PECOS PAC ID: 6103368600 Enrollment ID: I20240612002301 |
Hillary Schultz Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3681 Green Rd Ste 404, Beachwood, OH 44122 Phone: 216-342-5484 Fax: 216-450-1126 | |
Barbara L Ekelman Phd Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24100 Chagrin Blvd, Suite 385, Beachwood, OH 44122 Phone: 216-464-9000 | |
North Coast Mental Health Associates Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3690 Orange Pl, 430, Beachwood, OH 44122 Phone: 216-464-5330 | |
Cambios Counseling & Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 Richmond Rd Ste 1005, Beachwood, OH 44122 Phone: 216-230-9986 | |
Cleveland Behavioral Health, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 Auburn Dr, Suite 200, Beachwood, OH 44122 Phone: 216-378-7909 Fax: 216-378-7505 | |
Laurel G Kaiser Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 25201 Chagrin Blvd Ste 390, Beachwood, OH 44122 Phone: 216-282-7244 | |
Sage Insight Communication & Therapeutic Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3401 Enterprise Pkwy Ste 340-496, Beachwood, OH 44122 Phone: 216-496-2396 |