| Seniors Wellness Group Of Michigan, P.c. | |
|
221 S Main St Suite 201 Royal Oak MI 48067-2611 | |
| (248) 398-6459 | |
| Not Available |
| Full Name | Seniors Wellness Group Of Michigan, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 221 S Main St, Royal Oak, Michigan |
| Authorized Official Name and Position | Gregory Michael Kotlarz (OWNER) |
| Authorized Official Contact | 2483986459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seniors Wellness Group Of Michigan, P.c. 221 S Main St Suite 201 Royal Oak MI 48067-2611 Ph: (248) 398-6459 | Seniors Wellness Group Of Michigan, P.c. 221 S Main St Suite 201 Royal Oak MI 48067-2611 Ph: (248) 398-6459 |
| NPI Number | 1801848718 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 07/08/2022 |
| Certification Date | 07/08/2022 |
| Medicare PECOS PAC ID | 7012950462 |
|---|---|
| Medicare Enrollment ID | O20050607000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801848718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301006594 (Michigan) | Primary |
| Provider Name | Sharon M Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710915186 PECOS PAC ID: 7416856463 Enrollment ID: I20040108000234 |
| Provider Name | Rhonda B Levy-larson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295711455 PECOS PAC ID: 6406755404 Enrollment ID: I20040108000476 |
| Provider Name | Patricia H Barszenski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881681955 PECOS PAC ID: 5092777912 Enrollment ID: I20041102000653 |
| Provider Name | April L Neuwirth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821109646 PECOS PAC ID: 6507824752 Enrollment ID: I20041221000084 |
| Provider Name | Marcia A Kopacz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366512634 PECOS PAC ID: 9133166671 Enrollment ID: I20050415000194 |
| Provider Name | Heminder P Singh |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1659407799 PECOS PAC ID: 9830131259 Enrollment ID: I20050526000140 |
| Provider Name | Sherry L Lord |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124051271 PECOS PAC ID: 7214942465 Enrollment ID: I20060209000482 |
| Provider Name | Richard E James |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750325262 PECOS PAC ID: 7517979974 Enrollment ID: I20060629000196 |
| Provider Name | Lauren R Ungar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841351467 PECOS PAC ID: 0547364093 Enrollment ID: I20070322000592 |
| Provider Name | Theodore J Ruza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346392735 PECOS PAC ID: 4981704392 Enrollment ID: I20070714000101 |
| Provider Name | Corinne Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467495275 PECOS PAC ID: 8527156702 Enrollment ID: I20071126000117 |
| Provider Name | Victoria L Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841484920 PECOS PAC ID: 3274671284 Enrollment ID: I20091112000137 |
| Provider Name | Jane Kamau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396990016 PECOS PAC ID: 1658436522 Enrollment ID: I20091203000751 |
| Provider Name | Tiffany Z Tuttle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649574526 PECOS PAC ID: 3678756830 Enrollment ID: I20110324000910 |
| Provider Name | Yobany F Pardo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275828964 PECOS PAC ID: 8527035492 Enrollment ID: I20110627000178 |
| Provider Name | Andrea N Morrison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407145030 PECOS PAC ID: 6709054836 Enrollment ID: I20110715000601 |
| Provider Name | Jung Yoen Son |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033495643 PECOS PAC ID: 3476720707 Enrollment ID: I20120126000762 |
| Provider Name | David H Manchel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144267725 PECOS PAC ID: 8921016437 Enrollment ID: I20120319000664 |
| Provider Name | Paul R Wiese |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578901559 PECOS PAC ID: 8426284936 Enrollment ID: I20131111001062 |
| Provider Name | Hwa Soon Rim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982908844 PECOS PAC ID: 8820273899 Enrollment ID: I20140322000058 |
| Provider Name | Kelly A Kinsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215344684 PECOS PAC ID: 6608094776 Enrollment ID: I20140903000370 |
| Provider Name | Harmony L Mckay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053728923 PECOS PAC ID: 2062729361 Enrollment ID: I20150918002278 |
| Provider Name | Michelle L Kazmierski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639530967 PECOS PAC ID: 0244537488 Enrollment ID: I20160401001259 |
| Provider Name | Sarah I Tarbox-berry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982159646 PECOS PAC ID: 7416242482 Enrollment ID: I20160830001269 |
| Provider Name | Patricia M Imai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699225722 PECOS PAC ID: 5799063939 Enrollment ID: I20161024000922 |
| Provider Name | Lisa A Caffee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548706807 PECOS PAC ID: 4082996921 Enrollment ID: I20170130000095 |
| Provider Name | Karla Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518403153 PECOS PAC ID: 9032494000 Enrollment ID: I20170315000362 |
| Provider Name | Sara L Nagengast |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982708400 PECOS PAC ID: 9436420502 Enrollment ID: I20170808001559 |
| Provider Name | Mary N Monahan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699251538 PECOS PAC ID: 8325396922 Enrollment ID: I20180730001127 |
| Provider Name | Heidi H Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417483678 PECOS PAC ID: 0749530244 Enrollment ID: I20180904002436 |
| Provider Name | Anne M Kuzma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114402468 PECOS PAC ID: 9830435502 Enrollment ID: I20190117000407 |
| Provider Name | Megan M Meade-higgins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578963336 PECOS PAC ID: 7618198342 Enrollment ID: I20190409001736 |
| Provider Name | Rachel H Tuttle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366871709 PECOS PAC ID: 4183967193 Enrollment ID: I20190515000117 |
| Provider Name | Adam P Walters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619527140 PECOS PAC ID: 8426388588 Enrollment ID: I20191002003844 |
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