| Sheppard Pratt Physicians, P.a. | |
|
6501 N Charles St Baltimore MD 21204-6819 | |
| (410) 938-3150 | |
| (410) 938-3159 |
| Full Name | Sheppard Pratt Physicians, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6501 N Charles St, Baltimore, Maryland |
| Authorized Official Name and Position | Bonnie B. Katz (VP CORPORATE BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 4109383150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheppard Pratt Physicians, P.a. 6501 N Charles St Baltimore MD 21204-6819 Ph: (410) 938-3150 | Sheppard Pratt Physicians, P.a. 6501 N Charles St Baltimore MD 21204-6819 Ph: (410) 938-3150 |
| NPI Number | 1518990712 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 01/27/2009 |
| Medicare PECOS PAC ID | 8224937610 |
|---|---|
| Medicare Enrollment ID | O20040105000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518990712 | NPI | - | NPPES |
| 00Y734 | Other | DC | MEDICARE PTAN |
| 374114 | Other | MD | MAMSI COMMERCIAL INS # |
| 560801500 | Medicaid | MD | |
| 814L | Other | MD | MEDICARE - SPEC LOCAITONS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Janet Marie Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003922238 PECOS PAC ID: 2668363102 Enrollment ID: I20040324000481 |
| Provider Name | Richard L Taylor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982606406 PECOS PAC ID: 0648175000 Enrollment ID: I20040325001482 |
| Provider Name | Richard Morris Weisman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396746640 PECOS PAC ID: 2860485679 Enrollment ID: I20040407000361 |
| Provider Name | Debra L Heck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790807600 PECOS PAC ID: 8022002799 Enrollment ID: I20040414000635 |
| Provider Name | Anne L Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154541126 PECOS PAC ID: 5799770392 Enrollment ID: I20040414001687 |
| Provider Name | Mitul Dave |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396833604 PECOS PAC ID: 0941296842 Enrollment ID: I20040424000442 |
| Provider Name | Sara Rachael Uram |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093078982 PECOS PAC ID: 1052302924 Enrollment ID: I20040519001461 |
| Provider Name | Jennifer Bunkley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265677009 PECOS PAC ID: 4284618539 Enrollment ID: I20040615001206 |
| Provider Name | Sarah Lcsw-c Loeffler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568504777 PECOS PAC ID: 8729064696 Enrollment ID: I20040629001630 |
| Provider Name | Boglarka Szabo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457386252 PECOS PAC ID: 9638158736 Enrollment ID: I20040714000121 |
| Provider Name | Mohammad K Mohmand |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700933983 PECOS PAC ID: 6507846375 Enrollment ID: I20040722000441 |
| Provider Name | David S Arnold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700852084 PECOS PAC ID: 3375517998 Enrollment ID: I20040820000315 |
| Provider Name | Eric Samstad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952356776 PECOS PAC ID: 3577531474 Enrollment ID: I20040921000128 |
| Provider Name | Efigenia O Geli-geocadin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780781773 PECOS PAC ID: 1951202076 Enrollment ID: I20041022000022 |
| Provider Name | Daniel M Beaudry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972513141 PECOS PAC ID: 4486618840 Enrollment ID: I20041116000123 |
| Provider Name | Laura J Seidel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285659524 PECOS PAC ID: 8820053861 Enrollment ID: I20041201000432 |
| Provider Name | Ifeoma Thompson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861453375 PECOS PAC ID: 2163471871 Enrollment ID: I20050120000348 |
| Provider Name | Rama D Reddi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356476949 PECOS PAC ID: 4587613096 Enrollment ID: I20050121000248 |
| Provider Name | Syed W Rizvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396824363 PECOS PAC ID: 9931151784 Enrollment ID: I20050221000192 |
| Provider Name | Robin Toler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538288444 PECOS PAC ID: 6103879853 Enrollment ID: I20050223000168 |
| Provider Name | Charulata P Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255490686 PECOS PAC ID: 8325093248 Enrollment ID: I20050314000858 |
| Provider Name | Robert W Wisner Carlson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235126665 PECOS PAC ID: 8224085089 Enrollment ID: I20050404000726 |
| Provider Name | Samson Vimalananda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578500955 PECOS PAC ID: 2567400344 Enrollment ID: I20050421000950 |
| Provider Name | Benedicto Borja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891716940 PECOS PAC ID: 5395719314 Enrollment ID: I20050608000633 |
| Provider Name | Evangelia Houlaki Lignos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306902523 PECOS PAC ID: 4587608351 Enrollment ID: I20050613000868 |
| Provider Name | Naier A Anhary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689629552 PECOS PAC ID: 8921037177 Enrollment ID: I20050808000738 |
| Provider Name | Mohammad A Ansari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891874863 PECOS PAC ID: 3274567300 Enrollment ID: I20050919000859 |
| Provider Name | Annie S Michaels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396843645 PECOS PAC ID: 1456385632 Enrollment ID: I20051021000285 |
| Provider Name | Susan Ouellette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720164320 PECOS PAC ID: 4880611458 Enrollment ID: I20051102000358 |
| Provider Name | Yusuke Sagawa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922067438 PECOS PAC ID: 1951388107 Enrollment ID: I20060426000276 |
| Provider Name | Srirupa Sen Ghoshtagore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912994948 PECOS PAC ID: 3072525062 Enrollment ID: I20060609000145 |
| Provider Name | Fadi N Saikali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396787578 PECOS PAC ID: 1254330905 Enrollment ID: I20061207000306 |
| Provider Name | Elaine T Koukoulas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063505055 PECOS PAC ID: 4284633629 Enrollment ID: I20061212000282 |
| Provider Name | Immaculata M Ulu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740298579 PECOS PAC ID: 2860491834 Enrollment ID: I20061220000556 |
| Provider Name | Lisa L Ashton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083734974 PECOS PAC ID: 9436258936 Enrollment ID: I20070625000460 |
| Provider Name | Rajneesh Mahajan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558487355 PECOS PAC ID: 7719087675 Enrollment ID: I20070709000229 |
| Provider Name | Fred T Chan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548289135 PECOS PAC ID: 0143314658 Enrollment ID: I20070914000204 |
| Provider Name | Rachel F Plotnick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477508802 PECOS PAC ID: 0345335139 Enrollment ID: I20071009000625 |
| Provider Name | Jason H Addison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144366923 PECOS PAC ID: 3173612025 Enrollment ID: I20071130000252 |
| Provider Name | Chichuan Y Kaminski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427168772 PECOS PAC ID: 3274512686 Enrollment ID: I20080111000204 |
| Provider Name | Rekha P Motagi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679653901 PECOS PAC ID: 4486739398 Enrollment ID: I20080317000174 |
| Provider Name | Marsden H Mcguire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548327687 PECOS PAC ID: 6507942026 Enrollment ID: I20080325000195 |
| Provider Name | Ayodeji Oladipo Somefun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831165380 PECOS PAC ID: 8123040854 Enrollment ID: I20080610000600 |
| Provider Name | Charles L Woodruff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053315713 PECOS PAC ID: 3375441769 Enrollment ID: I20080811000598 |
| Provider Name | Margo D Lauterbach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285680322 PECOS PAC ID: 6002834959 Enrollment ID: I20080811000774 |
| Provider Name | Phillip S Brackin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386649267 PECOS PAC ID: 0840191474 Enrollment ID: I20080821000064 |
| Provider Name | Samia Babar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720266281 PECOS PAC ID: 8527134956 Enrollment ID: I20080908000485 |
| Provider Name | Jeannie Pham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720271430 PECOS PAC ID: 9032285317 Enrollment ID: I20080910000543 |
| Provider Name | Tyler C Hightower |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225199078 PECOS PAC ID: 5193892974 Enrollment ID: I20080919000271 |
| Provider Name | Olga M Rossello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326218371 PECOS PAC ID: 4385705706 Enrollment ID: I20081204000041 |
| Provider Name | Daniel S Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992742910 PECOS PAC ID: 8921010794 Enrollment ID: I20081211000076 |
| Provider Name | Peter M Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659516664 PECOS PAC ID: 5092878892 Enrollment ID: I20090105000459 |
| Provider Name | Naomi Constantine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225212756 PECOS PAC ID: 0143385732 Enrollment ID: I20090216000008 |
| Provider Name | Charles E Buckley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134128051 PECOS PAC ID: 1759446289 Enrollment ID: I20090218000074 |
| Provider Name | Cynthia A Lengrand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558508770 PECOS PAC ID: 2668539800 Enrollment ID: I20090316000271 |
| Provider Name | Maximilian Badoy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902954902 PECOS PAC ID: 5991795791 Enrollment ID: I20090331000416 |
| Provider Name | Meenakshi Suman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922130483 PECOS PAC ID: 6406903913 Enrollment ID: I20090421000551 |
| Provider Name | Desmond M Kaplan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811044092 PECOS PAC ID: 1153479704 Enrollment ID: I20090508000234 |
| Provider Name | Timothy T Jiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396769659 PECOS PAC ID: 9638229230 Enrollment ID: I20090602000272 |
| Provider Name | Inwha Cho |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861451767 PECOS PAC ID: 3072673490 Enrollment ID: I20090604000219 |
| Provider Name | Susan B Wait |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881754117 PECOS PAC ID: 8820149370 Enrollment ID: I20090624000276 |
| Provider Name | Meenakshi Vimalananda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235272378 PECOS PAC ID: 0446301816 Enrollment ID: I20090624000496 |
| Provider Name | Haysam Ghannoum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205883220 PECOS PAC ID: 3870482086 Enrollment ID: I20091008000077 |
| Provider Name | Yang-en Kao |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1326013319 PECOS PAC ID: 0648316299 Enrollment ID: I20091013000009 |
| Provider Name | Oscar Galvis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275517567 PECOS PAC ID: 9335286764 Enrollment ID: I20091016000405 |
| Provider Name | Jodi L Berg-gaither |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023157930 PECOS PAC ID: 5193864106 Enrollment ID: I20091216000395 |
| Provider Name | Reono Bertagnolli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558352948 PECOS PAC ID: 8426124231 Enrollment ID: I20100405000049 |
| Provider Name | Thomas Colligan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316276900 PECOS PAC ID: 9133256266 Enrollment ID: I20100422000132 |
| Provider Name | Ramesh Sabapathi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730118993 PECOS PAC ID: 9638120082 Enrollment ID: I20100517000734 |
| Provider Name | Tiffany L Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689991473 PECOS PAC ID: 3577693134 Enrollment ID: I20100609000394 |
| Provider Name | Catherine Lynn Harrison Restelli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609042852 PECOS PAC ID: 8224168745 Enrollment ID: I20100610000126 |
| Provider Name | Brenda Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366761371 PECOS PAC ID: 0244361095 Enrollment ID: I20100623000665 |
| Provider Name | Nicola G Cascella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427007681 PECOS PAC ID: 9335270834 Enrollment ID: I20100628000465 |
| Provider Name | Vassilis E Koliatsos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679623045 PECOS PAC ID: 1951425842 Enrollment ID: I20100830000491 |
| Provider Name | Sunil Khushalani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710085956 PECOS PAC ID: 6901920750 Enrollment ID: I20100831000143 |
| Provider Name | Merle Mccann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740347889 PECOS PAC ID: 2769506278 Enrollment ID: I20100903000555 |
| Provider Name | Carla Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790905826 PECOS PAC ID: 8224153911 Enrollment ID: I20100917001028 |
| Provider Name | Robert P Roca |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1982785069 PECOS PAC ID: 3870619026 Enrollment ID: I20100925000110 |
| Provider Name | Andrew C Warren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730287954 PECOS PAC ID: 7719179340 Enrollment ID: I20101014000158 |
| Provider Name | Edward Zuzarte |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366598252 PECOS PAC ID: 9234321894 Enrollment ID: I20101014000628 |
| Provider Name | Matthew J. Mee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134277817 PECOS PAC ID: 8527250117 Enrollment ID: I20101014000899 |
| Provider Name | Dennis J. Kutzer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326191362 PECOS PAC ID: 0143414722 Enrollment ID: I20101027000991 |
| Provider Name | Cynthia L Dinardo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437290343 PECOS PAC ID: 0648464925 Enrollment ID: I20101101000150 |
| Provider Name | Anne H Seiler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215014808 PECOS PAC ID: 6204020423 Enrollment ID: I20101102000539 |
| Provider Name | Faith B Dickerson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811053499 PECOS PAC ID: 3173719721 Enrollment ID: I20101123000052 |
| Provider Name | William R Keller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477678985 PECOS PAC ID: 9234325556 Enrollment ID: I20101130000038 |
| Provider Name | Ihuoma N Okezie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568649366 PECOS PAC ID: 7113088568 Enrollment ID: I20101206000209 |
| Provider Name | Deoroop Gurprasad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184836462 PECOS PAC ID: 1456548213 Enrollment ID: I20101207000411 |
| Provider Name | Judith L Ward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124232533 PECOS PAC ID: 3173710563 Enrollment ID: I20101210000766 |
| Provider Name | Damani B Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073642310 PECOS PAC ID: 2769671692 Enrollment ID: I20110107000721 |
| Provider Name | Nicole T Newhouse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255647939 PECOS PAC ID: 3476740812 Enrollment ID: I20110111000805 |
| Provider Name | Anis Merson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578524120 PECOS PAC ID: 8123207602 Enrollment ID: I20110131000242 |
| Provider Name | Sonja G Schaffer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902870207 PECOS PAC ID: 3779505474 Enrollment ID: I20110323000794 |
| Provider Name | George G Brackin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811985500 PECOS PAC ID: 5092794222 Enrollment ID: I20110323000818 |
| Provider Name | Rebekah Gildersleeve |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497051833 PECOS PAC ID: 2769667021 Enrollment ID: I20110502000087 |
| Provider Name | Arachchige Muthukuda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073770616 PECOS PAC ID: 9638354608 Enrollment ID: I20110506000607 |
| Provider Name | Nadia Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902093925 PECOS PAC ID: 2860540754 Enrollment ID: I20110510000767 |
| Provider Name | Milap A Nowrangi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902065410 PECOS PAC ID: 1153507843 Enrollment ID: I20110513000276 |
| Provider Name | Crystal Watkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558408542 PECOS PAC ID: 9133306020 Enrollment ID: I20110601000564 |
| Provider Name | Maju Koola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578602512 PECOS PAC ID: 7911185186 Enrollment ID: I20110617000523 |
| Provider Name | Elizabeth Galik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124028261 PECOS PAC ID: 7113195777 Enrollment ID: I20110726000391 |
| Provider Name | Douglas Gartrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023243417 PECOS PAC ID: 0244403905 Enrollment ID: I20111026000067 |
| Provider Name | Constance N Flanagan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891946810 PECOS PAC ID: 5991970345 Enrollment ID: I20111213000542 |
| Provider Name | Jessie Stephen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780845842 PECOS PAC ID: 6305006164 Enrollment ID: I20120402000333 |
| Provider Name | Virginia S Villani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174565477 PECOS PAC ID: 0840451159 Enrollment ID: I20120413000160 |
| Provider Name | Khizar Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427090497 PECOS PAC ID: 7113824392 Enrollment ID: I20120504000022 |
| Provider Name | Enrique I Oviedo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255534756 PECOS PAC ID: 2769644764 Enrollment ID: I20120509000422 |
| Provider Name | Anibal Cravchik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124358163 PECOS PAC ID: 7911172887 Enrollment ID: I20120606000107 |
| Provider Name | Aruna S. Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497795926 PECOS PAC ID: 6800804675 Enrollment ID: I20120720000137 |
| Provider Name | Savitha Puttaiah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255594032 PECOS PAC ID: 0345406799 Enrollment ID: I20120730000483 |
| Provider Name | Jill A Burgholzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538440862 PECOS PAC ID: 2365698214 Enrollment ID: I20120808000363 |
| Provider Name | Amanda L Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770888521 PECOS PAC ID: 3577719103 Enrollment ID: I20120814000124 |
| Provider Name | Patrick M Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215284815 PECOS PAC ID: 2860640760 Enrollment ID: I20120919000058 |
| Provider Name | Jonathan Honigsbaum Holt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679540561 PECOS PAC ID: 3779507645 Enrollment ID: I20120920000438 |
| Provider Name | Tammy Acker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225384431 PECOS PAC ID: 8123277050 Enrollment ID: I20121009000286 |
| Provider Name | Diana Marie Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942646591 PECOS PAC ID: 0446499362 Enrollment ID: I20130625000257 |
| Provider Name | Ashley Nicole Mckenzie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346501616 PECOS PAC ID: 4688815798 Enrollment ID: I20130731000715 |
| Provider Name | Rachna S Raisinghani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073777587 PECOS PAC ID: 7517107725 Enrollment ID: I20130815000322 |
| Provider Name | Rachel Gail Burgan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629172143 PECOS PAC ID: 8628211620 Enrollment ID: I20130823000158 |
| Provider Name | Debra Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831419100 PECOS PAC ID: 2668607946 Enrollment ID: I20131022000638 |
| Provider Name | Teresa Huchun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316971419 PECOS PAC ID: 7113999046 Enrollment ID: I20131204001682 |
| Provider Name | Maurice Bachawati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366425779 PECOS PAC ID: 7517151343 Enrollment ID: I20140513000443 |
| Provider Name | Mark W Meyermann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609925338 PECOS PAC ID: 5193965960 Enrollment ID: I20140715000202 |
| Provider Name | Jessica V Merkel-keller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437448107 PECOS PAC ID: 7113176280 Enrollment ID: I20140806002284 |
| Provider Name | Tamela Mcclam |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1205095098 PECOS PAC ID: 7315175981 Enrollment ID: I20140820000949 |
| Provider Name | Benjamin T Huang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548289416 PECOS PAC ID: 2365345089 Enrollment ID: I20140904000395 |
| Provider Name | Munachim Uyanwune |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710203591 PECOS PAC ID: 8022236967 Enrollment ID: I20140905001550 |
| Provider Name | Manan J Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245469089 PECOS PAC ID: 7315174299 Enrollment ID: I20140917001143 |
| Provider Name | Yakir Vaks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104086776 PECOS PAC ID: 4981843851 Enrollment ID: I20141003000853 |
| Provider Name | Jaya Praveen Kumar Penagaluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124258645 PECOS PAC ID: 6709037781 Enrollment ID: I20141117000151 |
| Provider Name | Weronika Micula-gondek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760682942 PECOS PAC ID: 8123342466 Enrollment ID: I20150115001090 |
| Provider Name | Elizabeth A Goldberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245631829 PECOS PAC ID: 5890019822 Enrollment ID: I20150122002629 |
| Provider Name | David C Call |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245558477 PECOS PAC ID: 4183948979 Enrollment ID: I20150127001859 |
| Provider Name | Sylvia Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962716571 PECOS PAC ID: 0345565867 Enrollment ID: I20150204001077 |
| Provider Name | Abdolazim Shahsavar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598064859 PECOS PAC ID: 0042466104 Enrollment ID: I20150410000979 |
| Provider Name | Jocelyn Malone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750631941 PECOS PAC ID: 5991023038 Enrollment ID: I20150421001580 |
| Provider Name | Erica Louise Sacchetti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679967426 PECOS PAC ID: 3072833029 Enrollment ID: I20150515000065 |
| Provider Name | Patricia Caraballo Osorio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164762688 PECOS PAC ID: 8325280464 Enrollment ID: I20150619001653 |
| Provider Name | Fauzia Nisar Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861703902 PECOS PAC ID: 8729390315 Enrollment ID: I20150710001047 |
| Provider Name | Sarah Jacqueline Herts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093094740 PECOS PAC ID: 9638482987 Enrollment ID: I20150716000924 |
| Provider Name | Laura Elhamy Eskander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932408424 PECOS PAC ID: 0244543403 Enrollment ID: I20150716001413 |
| Provider Name | Robert Johannes Schloesser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902195878 PECOS PAC ID: 7315250370 Enrollment ID: I20150720002162 |
| Provider Name | Penny L Timmons Lemmerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760674576 PECOS PAC ID: 4981919552 Enrollment ID: I20150812007275 |
| Provider Name | Osama Abulseoud |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679654800 PECOS PAC ID: 3678573045 Enrollment ID: I20150827000147 |
| Provider Name | Robert T Paine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780974345 PECOS PAC ID: 1759531882 Enrollment ID: I20150827001985 |
| Provider Name | Lindsay D Holbein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760852727 PECOS PAC ID: 2466752431 Enrollment ID: I20151123002168 |
| Provider Name | Susannah Kate Dowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710368733 PECOS PAC ID: 7012218472 Enrollment ID: I20151209001878 |
| Provider Name | Muhammad Haroon Burhanullah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972824340 PECOS PAC ID: 6204146707 Enrollment ID: I20160104002041 |
| Provider Name | Ariel A Vitali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548452147 PECOS PAC ID: 7214080795 Enrollment ID: I20160105001880 |
| Provider Name | Silvio Saidemberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326225459 PECOS PAC ID: 4385686344 Enrollment ID: I20160218001278 |
| Provider Name | Ebony Maynard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497117287 PECOS PAC ID: 1355649286 Enrollment ID: I20160411000468 |
| Provider Name | Elizabeth Quill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699131755 PECOS PAC ID: 7911206693 Enrollment ID: I20160502000792 |
| Provider Name | Janet Marie Abrams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346697505 PECOS PAC ID: 8325330533 Enrollment ID: I20160708001209 |
| Provider Name | Scott Robert Pekrul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740485671 PECOS PAC ID: 2365697000 Enrollment ID: I20160719002304 |
| Provider Name | Yuelei Dong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598030645 PECOS PAC ID: 0648578955 Enrollment ID: I20160801000713 |
| Provider Name | Benjamin Simon Preston Israel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073870390 PECOS PAC ID: 6507164894 Enrollment ID: I20160803000065 |
| Provider Name | Rachel Ann Smolowitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104079052 PECOS PAC ID: 9537453329 Enrollment ID: I20160803000169 |
| Provider Name | Charlene Marie Rozich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760726269 PECOS PAC ID: 3072758556 Enrollment ID: I20160804000040 |
| Provider Name | Kristen Gialo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659647220 PECOS PAC ID: 2961700174 Enrollment ID: I20160811001366 |
| Provider Name | Deborah Michelle Brooks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164798419 PECOS PAC ID: 4880992288 Enrollment ID: I20160812000091 |
| Provider Name | Taranjeet Jolly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689954059 PECOS PAC ID: 6901191402 Enrollment ID: I20160823001939 |
| Provider Name | Kirsten Carol George |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1194042747 PECOS PAC ID: 3678871837 Enrollment ID: I20160829001094 |
| Provider Name | Emily Bomasang-layno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336435544 PECOS PAC ID: 9436453271 Enrollment ID: I20160831000864 |
| Provider Name | Zhihong Guo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326208984 PECOS PAC ID: 3577859412 Enrollment ID: I20160901001366 |
| Provider Name | Mary G Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023449642 PECOS PAC ID: 2567687767 Enrollment ID: I20161003001632 |
| Provider Name | Yuanfen Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306282249 PECOS PAC ID: 1355629395 Enrollment ID: I20161026002629 |
| Provider Name | Jennifer Anne Addis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528500741 PECOS PAC ID: 1759664576 Enrollment ID: I20170201002105 |
| Provider Name | James Young Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629447321 PECOS PAC ID: 2769765924 Enrollment ID: I20170214000166 |
| Provider Name | Rita E Pyuzza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083158158 PECOS PAC ID: 4880979533 Enrollment ID: I20170321001881 |
| Provider Name | Carolyn Calleo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295270445 PECOS PAC ID: 0749566149 Enrollment ID: I20170420000271 |
| Provider Name | Ameena S Jain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093064073 PECOS PAC ID: 9537318787 Enrollment ID: I20170426002742 |
| Provider Name | Rebecca Ruth Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154549269 PECOS PAC ID: 3870692205 Enrollment ID: I20170601000405 |
| Provider Name | Christopher Brian Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578095444 PECOS PAC ID: 3476822180 Enrollment ID: I20170711002857 |
| Provider Name | Radha V Gholkar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346401924 PECOS PAC ID: 5799056123 Enrollment ID: I20170803002366 |
| Provider Name | Christine Tran-boynes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801138458 PECOS PAC ID: 5496053829 Enrollment ID: I20170809003030 |
| Provider Name | Hilarie Lynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033641089 PECOS PAC ID: 5698047009 Enrollment ID: I20170821000704 |
| Provider Name | Hannah Buekie Alorgbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184176299 PECOS PAC ID: 8325311277 Enrollment ID: I20170829002137 |
| Provider Name | Chinenyenwa Onyemaechi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396087052 PECOS PAC ID: 9234438433 Enrollment ID: I20170907000277 |
| Provider Name | Ameya Umakant Amritwar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023445772 PECOS PAC ID: 4880972488 Enrollment ID: I20171011000241 |
| Provider Name | Katharine A Sewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689199259 PECOS PAC ID: 6002172434 Enrollment ID: I20171117000484 |
| Provider Name | Rachel Veronica Hansberger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912410424 PECOS PAC ID: 2062770951 Enrollment ID: I20171226000838 |
| Provider Name | Sandra Onyeagoro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104053362 PECOS PAC ID: 8921237256 Enrollment ID: I20171227000129 |
| Provider Name | Vittoria Delucia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306188941 PECOS PAC ID: 7911205166 Enrollment ID: I20180523001578 |
| Provider Name | Xian Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548686256 PECOS PAC ID: 2961768114 Enrollment ID: I20180524001983 |
| Provider Name | Michelle Lynn Ridgeway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730677121 PECOS PAC ID: 3577828912 Enrollment ID: I20180605003250 |
| Provider Name | Catharyn Alva Turner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649595539 PECOS PAC ID: 6507087269 Enrollment ID: I20180718003033 |
| Provider Name | Junyong Jia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972998052 PECOS PAC ID: 6800143009 Enrollment ID: I20180719000205 |
| Provider Name | Rebekah Hagan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093112666 PECOS PAC ID: 6608123369 Enrollment ID: I20180726000917 |
| Provider Name | Rebecca Sokal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366860611 PECOS PAC ID: 9638477060 Enrollment ID: I20180726003276 |
| Provider Name | Rawnie James Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629269436 PECOS PAC ID: 3072861459 Enrollment ID: I20180801000736 |
| Provider Name | Todd Erik Peters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467515213 PECOS PAC ID: 5597934562 Enrollment ID: I20180802000901 |
| Provider Name | Kirsten Leah Kleczek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982195699 PECOS PAC ID: 0143578237 Enrollment ID: I20180807000014 |
| Provider Name | Anita Iype |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639598907 PECOS PAC ID: 1557581089 Enrollment ID: I20180814001234 |
| Provider Name | Alice Shin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972917813 PECOS PAC ID: 8426378209 Enrollment ID: I20180823003338 |
| Provider Name | Vedrana Hodzic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346667201 PECOS PAC ID: 9638478829 Enrollment ID: I20180911000289 |
| Provider Name | Bharat Narapareddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275953861 PECOS PAC ID: 3072864768 Enrollment ID: I20180919001310 |
| Provider Name | Allison Theresa Plucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205180742 PECOS PAC ID: 6507179710 Enrollment ID: I20181010000512 |
| Provider Name | Crystal Salcido |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013334929 PECOS PAC ID: 9931323300 Enrollment ID: I20181010000868 |
| Provider Name | Marjorie J Warren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649364779 PECOS PAC ID: 6800886631 Enrollment ID: I20181010002220 |
| Provider Name | Phoebe Antoinette Underwood-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457844722 PECOS PAC ID: 6800148123 Enrollment ID: I20181015000317 |
| Provider Name | Daramola Ayoade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922587120 PECOS PAC ID: 4688919194 Enrollment ID: I20190102001359 |
| Provider Name | Daniel Lowenstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871903021 PECOS PAC ID: 9436458494 Enrollment ID: I20190130002419 |
| Provider Name | Joel E Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508338203 PECOS PAC ID: 9133468143 Enrollment ID: I20190307003227 |
| Provider Name | Deepak Prabhakar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952565764 PECOS PAC ID: 9739324898 Enrollment ID: I20190418000222 |
| Provider Name | Mary N Zelio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588901946 PECOS PAC ID: 8123351400 Enrollment ID: I20190603000241 |
| Provider Name | Christopher R Carr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215593504 PECOS PAC ID: 7416280649 Enrollment ID: I20190603003007 |
| Provider Name | Elizabeth Ryznar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811381049 PECOS PAC ID: 7214231067 Enrollment ID: I20190710002170 |
| Provider Name | Anise Zamora Noggle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912326943 PECOS PAC ID: 0042509036 Enrollment ID: I20190716000834 |
| Provider Name | Jennifer L Goetz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871931956 PECOS PAC ID: 1658509757 Enrollment ID: I20190719002079 |
| Provider Name | Adefolake Akinsanya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316353816 PECOS PAC ID: 1254631781 Enrollment ID: I20190722000404 |
| Provider Name | Vikas Kumar Sinha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407297567 PECOS PAC ID: 3072841535 Enrollment ID: I20190821002243 |
| Provider Name | Monica Neugebauer Rettenmier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558780890 PECOS PAC ID: 0042513681 Enrollment ID: I20190826000439 |
| Provider Name | Albert N Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902290125 PECOS PAC ID: 3072811280 Enrollment ID: I20190827001199 |
| Provider Name | Jenel Latoya Morian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174939755 PECOS PAC ID: 9638407596 Enrollment ID: I20190910000845 |
| Provider Name | Ronald Hung Wei Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871759761 PECOS PAC ID: 5294984084 Enrollment ID: I20190924002943 |
| Provider Name | Sarah M Swenson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821465030 PECOS PAC ID: 4486984937 Enrollment ID: I20190925002787 |
| Provider Name | John William Kasckow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508879842 PECOS PAC ID: 4486544640 Enrollment ID: I20190925003228 |
| Provider Name | Caroline E Santos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326493172 PECOS PAC ID: 1254763451 Enrollment ID: I20191108001047 |
| Provider Name | Matthew Jamal Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457902710 PECOS PAC ID: 8820420094 Enrollment ID: I20191111000905 |
| Provider Name | Deborah E Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437620630 PECOS PAC ID: 3870817216 Enrollment ID: I20191112000318 |
| Provider Name | Nicholas Aldeen Waldhaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275183717 PECOS PAC ID: 9335571207 Enrollment ID: I20191114000846 |
| Provider Name | Patricia Lynn Carlson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326178500 PECOS PAC ID: 5294865473 Enrollment ID: I20191121002519 |
| Provider Name | Markian Y Pazuniak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205218757 PECOS PAC ID: 9638410079 Enrollment ID: I20191216002386 |
| Provider Name | Mahta Laghaie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003453630 PECOS PAC ID: 1951736461 Enrollment ID: I20200110000369 |
| Provider Name | Ashley Ann Lester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003452624 PECOS PAC ID: 5395171920 Enrollment ID: I20200130000988 |
| Provider Name | Susan Jane Girod |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568516680 PECOS PAC ID: 9537110812 Enrollment ID: I20200219000201 |
| Provider Name | Naveed Sultan Bajwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245874361 PECOS PAC ID: 1951738277 Enrollment ID: I20200227000049 |
| Provider Name | Ayorinde Oluwagbeniga Oyeneyin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932746062 PECOS PAC ID: 9335576545 Enrollment ID: I20200228000943 |
| Provider Name | Mavis Kisseadoo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366081887 PECOS PAC ID: 5193152205 Enrollment ID: I20200303000836 |
| Provider Name | Sarah Rebekah Langham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942668785 PECOS PAC ID: 9032416722 Enrollment ID: I20200311000122 |
| Provider Name | Jaclyn Blaire Daugherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477197424 PECOS PAC ID: 5294164984 Enrollment ID: I20200331003533 |
| Provider Name | Louis John Marino |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1194739607 PECOS PAC ID: 6002082120 Enrollment ID: I20200403002556 |
| Provider Name | Keith Reilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770128712 PECOS PAC ID: 5092146217 Enrollment ID: I20200504000013 |
| Provider Name | Kimberly Anne Toepfer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407485907 PECOS PAC ID: 6305277567 Enrollment ID: I20200504001796 |
| Provider Name | Iwalola Stella Omojola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477181857 PECOS PAC ID: 4981035854 Enrollment ID: I20200508000558 |
| Provider Name | Susan Catherine Tossman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649800616 PECOS PAC ID: 6800217183 Enrollment ID: I20200526000060 |
| Provider Name | Felecia Traynham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245851161 PECOS PAC ID: 3375964414 Enrollment ID: I20200528001496 |
| Provider Name | Cashana Monique Betterly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972967263 PECOS PAC ID: 5294027207 Enrollment ID: I20200612000838 |
| Provider Name | Ubachi Nonye Chukwuzubelu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700422177 PECOS PAC ID: 8325461452 Enrollment ID: I20200708002503 |
| Provider Name | Melissa Danielle Mainier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043833098 PECOS PAC ID: 9032532676 Enrollment ID: I20200715000218 |
| Provider Name | Alyssa S Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528601036 PECOS PAC ID: 7113341348 Enrollment ID: I20200721003836 |
| Provider Name | Emily Haas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891157160 PECOS PAC ID: 2163717133 Enrollment ID: I20200728000839 |
| Provider Name | Swaminathan Thangaraj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023499571 PECOS PAC ID: 3779832688 Enrollment ID: I20200811004085 |
| Provider Name | Ketankumar V Bodarya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831496165 PECOS PAC ID: 9032409313 Enrollment ID: I20200826000088 |
| Provider Name | Nadimire Jules-dole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750657987 PECOS PAC ID: 9638420029 Enrollment ID: I20200826003650 |
| Provider Name | Jyoti Rimal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356953327 PECOS PAC ID: 1153749056 Enrollment ID: I20200909001437 |
| Provider Name | Bimla Rai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689069627 PECOS PAC ID: 6608127451 Enrollment ID: I20200916000109 |
| Provider Name | Lisa Marie Hoffmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750901849 PECOS PAC ID: 1557780202 Enrollment ID: I20200929002388 |
| Provider Name | Tolulope Taiwo Peters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942567185 PECOS PAC ID: 2860634920 Enrollment ID: I20201009001552 |
| Provider Name | Duaa Tolba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124632708 PECOS PAC ID: 2264852557 Enrollment ID: I20201027001365 |
| Provider Name | Whitney Withrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477150522 PECOS PAC ID: 2466862693 Enrollment ID: I20201029001195 |
| Provider Name | Ashley Alayna Maher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891334595 PECOS PAC ID: 0749690436 Enrollment ID: I20201109001894 |
| Provider Name | Dwayne Narayan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083619951 PECOS PAC ID: 5597909192 Enrollment ID: I20201120001867 |
| Provider Name | James Lamousin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043227606 PECOS PAC ID: 8022000215 Enrollment ID: I20201120002566 |
| Provider Name | Gregory Renck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275645400 PECOS PAC ID: 2668557455 Enrollment ID: I20201125000586 |
| Provider Name | Ethan Bennett Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447862305 PECOS PAC ID: 0446661979 Enrollment ID: I20201204000543 |
| Provider Name | Ehsan Ullah Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932422482 PECOS PAC ID: 3375738776 Enrollment ID: I20201216000016 |
| Provider Name | Deval D. Zaveri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245407477 PECOS PAC ID: 1759512551 Enrollment ID: I20201229002578 |
| Provider Name | Steven Royce Woods |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386923357 PECOS PAC ID: 7517204837 Enrollment ID: I20210105002574 |
| Provider Name | Insley Schaden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598357691 PECOS PAC ID: 4880009802 Enrollment ID: I20210224001201 |
| Provider Name | Ashley Kendrick Gyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710575808 PECOS PAC ID: 4082020995 Enrollment ID: I20210301001364 |
| Provider Name | Yaakov Shugarman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023594017 PECOS PAC ID: 9032526736 Enrollment ID: I20210325000085 |
| Provider Name | Jourdan Aromin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598150955 PECOS PAC ID: 4082942776 Enrollment ID: I20210428000243 |
| Provider Name | Kamiylah Abdul Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003403031 PECOS PAC ID: 4880003094 Enrollment ID: I20210429000223 |
| Provider Name | Rebecca Lynn Biggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871176156 PECOS PAC ID: 1153730007 Enrollment ID: I20210506000805 |
| Provider Name | Hillary F. Mallette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124688205 PECOS PAC ID: 3779982327 Enrollment ID: I20210602000024 |
| Provider Name | Candace Womack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578141602 PECOS PAC ID: 9133529936 Enrollment ID: I20210616001221 |
| Provider Name | Agnes Mensah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760072979 PECOS PAC ID: 0749680221 Enrollment ID: I20210621003071 |
| Provider Name | Brenda Folefac Fonju |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174102610 PECOS PAC ID: 2365843877 Enrollment ID: I20210622000854 |
| Provider Name | Olawunmi Olufowobi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316531353 PECOS PAC ID: 2567863137 Enrollment ID: I20210702001624 |
| Provider Name | Paul Adam Fuchs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649624396 PECOS PAC ID: 4183917610 Enrollment ID: I20210706000700 |
| Provider Name | Trevor Rishawn Marquis York |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174054456 PECOS PAC ID: 6608112370 Enrollment ID: I20210706003490 |
| Provider Name | Megan C Bowers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659660678 PECOS PAC ID: 1557763927 Enrollment ID: I20210707002727 |
| Provider Name | Afifa Adiba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225480031 PECOS PAC ID: 0446548135 Enrollment ID: I20210708003239 |
| Provider Name | Jessica Yang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386098127 PECOS PAC ID: 3577807015 Enrollment ID: I20210712001316 |
| Provider Name | Jeffrey F Liubicich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730576257 PECOS PAC ID: 4486957867 Enrollment ID: I20210715002805 |
| Provider Name | Susan A Waterman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376749333 PECOS PAC ID: 9537588819 Enrollment ID: I20210715003181 |
| Provider Name | Hannah Rose Balleza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508307943 PECOS PAC ID: 4688945587 Enrollment ID: I20210729003821 |
| Provider Name | Rachel Kennedy Delany |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689088858 PECOS PAC ID: 6507155363 Enrollment ID: I20210816000378 |
| Provider Name | Amrit Kaur Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225688914 PECOS PAC ID: 7618372921 Enrollment ID: I20210825002025 |
| Provider Name | Thickness Patrick Egwuatu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053997122 PECOS PAC ID: 8628474871 Enrollment ID: I20210927000724 |
| Provider Name | Christine Alero Kalu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427627066 PECOS PAC ID: 6305244401 Enrollment ID: I20211004002126 |
| Provider Name | Ugonma Imo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225705346 PECOS PAC ID: 5193123503 Enrollment ID: I20211014001761 |
| Provider Name | Raphael Ernest Gikonyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205458536 PECOS PAC ID: 6608264296 Enrollment ID: I20211101003044 |
| Provider Name | Kathleen Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528720018 PECOS PAC ID: 9032507645 Enrollment ID: I20211102000353 |
| Provider Name | Kelly A Farrish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649946849 PECOS PAC ID: 9133517592 Enrollment ID: I20211104000403 |
| Provider Name | Natalie Ann Marchione |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992327035 PECOS PAC ID: 5496144776 Enrollment ID: I20211108000007 |
| Provider Name | Alicia Marhefka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588197172 PECOS PAC ID: 8224306964 Enrollment ID: I20211207001516 |
| Provider Name | Queen Bisola Mumuney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700341856 PECOS PAC ID: 6800286899 Enrollment ID: I20211230000012 |
| Provider Name | Martine Senatus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548602063 PECOS PAC ID: 1557582939 Enrollment ID: I20220125002923 |
| Provider Name | Brian P Quigley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063617033 PECOS PAC ID: 6507966207 Enrollment ID: I20220126001446 |
| Provider Name | Stephen Hurwitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134145592 PECOS PAC ID: 0749213221 Enrollment ID: I20220126002040 |
| Provider Name | Michelle Schofield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104874056 PECOS PAC ID: 2062437106 Enrollment ID: I20220127000990 |
| Provider Name | Ernest Spiotto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902331747 PECOS PAC ID: 2961772314 Enrollment ID: I20220128002017 |
| Provider Name | Nancy Carisa Fouts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073978417 PECOS PAC ID: 1456656487 Enrollment ID: I20220201000114 |
| Provider Name | Wendol Arthur Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851380612 PECOS PAC ID: 2860460367 Enrollment ID: I20220207000496 |
| Provider Name | Devi Bhuyan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164969903 PECOS PAC ID: 4880087071 Enrollment ID: I20220211000167 |
| Provider Name | Jenifer Tatiana Akosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821756495 PECOS PAC ID: 0840683835 Enrollment ID: I20220216000636 |
| Provider Name | Allyson Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760050983 PECOS PAC ID: 3375938194 Enrollment ID: I20220315000020 |
| Provider Name | Gwendolin Tifang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700544707 PECOS PAC ID: 7113312810 Enrollment ID: I20220316000477 |
| Provider Name | Liz Np Nangendo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689108730 PECOS PAC ID: 6204100886 Enrollment ID: I20220411000304 |
| Provider Name | Nitin Kamble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811214737 PECOS PAC ID: 9436456142 Enrollment ID: I20220822002638 |
| Provider Name | Andrew Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295171734 PECOS PAC ID: 9537420245 Enrollment ID: I20220826001133 |
| Provider Name | Surinder Singh Moonga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851898019 PECOS PAC ID: 2062764285 Enrollment ID: I20220908000031 |
| Provider Name | Sabreen R Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689833824 PECOS PAC ID: 4688857543 Enrollment ID: I20220909002200 |
| Provider Name | Erika Laufer Humphreys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801524715 PECOS PAC ID: 9537544689 Enrollment ID: I20220910000238 |
| Provider Name | Francisca Obi Bisong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467032284 PECOS PAC ID: 1355727553 Enrollment ID: I20220926000705 |
| Provider Name | Angenette C Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780318519 PECOS PAC ID: 4183090319 Enrollment ID: I20221013001321 |
| Provider Name | Aisha Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942737069 PECOS PAC ID: 9234408881 Enrollment ID: I20221109001208 |
| Provider Name | Taniya Pradhan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275709859 PECOS PAC ID: 3274751706 Enrollment ID: I20221110000144 |
| Provider Name | Tiffany Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376275834 PECOS PAC ID: 2668841883 Enrollment ID: I20221212000013 |
| Provider Name | Breanna Kelz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760116354 PECOS PAC ID: 6901276534 Enrollment ID: I20221223000018 |
| Provider Name | Miriam Siri A Ambe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255901872 PECOS PAC ID: 0244600427 Enrollment ID: I20230104001652 |
| Provider Name | Gelila Retta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942895172 PECOS PAC ID: 5193197689 Enrollment ID: I20230209001463 |
| Provider Name | Francis Achanyileke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407113285 PECOS PAC ID: 3870965957 Enrollment ID: I20230220000097 |
| Provider Name | Oscar G Morales |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851367130 PECOS PAC ID: 8820063696 Enrollment ID: I20230222000234 |
| Provider Name | Julia Weckstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376030684 PECOS PAC ID: 7618214958 Enrollment ID: I20230228003286 |
| Provider Name | Marissa Stanziani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205405941 PECOS PAC ID: 2163895772 Enrollment ID: I20230302000135 |
| Provider Name | Oluwasola Morakinyo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184129074 PECOS PAC ID: 5496001448 Enrollment ID: I20230329001139 |
| Provider Name | Anna T Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356783476 PECOS PAC ID: 6608231394 Enrollment ID: I20230502003224 |
| Provider Name | Chad Lennon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427373687 PECOS PAC ID: 1355632001 Enrollment ID: I20230511000949 |
| Provider Name | Fahad Mukhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427589142 PECOS PAC ID: 8224494091 Enrollment ID: I20230522000097 |
| Provider Name | Uzoamaka Mbadugha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912606385 PECOS PAC ID: 1850758335 Enrollment ID: I20230530001136 |
| Provider Name | Christina Schin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164088985 PECOS PAC ID: 4183950421 Enrollment ID: I20230531000256 |
| Provider Name | Adekunle Adegbesan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710610126 PECOS PAC ID: 2466819743 Enrollment ID: I20230531003177 |
| Provider Name | Chelsea Cosner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003393380 PECOS PAC ID: 8921339177 Enrollment ID: I20230601001426 |
| Provider Name | Farha B Motiwala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568897015 PECOS PAC ID: 3274862487 Enrollment ID: I20230602000429 |
| Provider Name | Rida Malick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083110167 PECOS PAC ID: 4688059488 Enrollment ID: I20230620003256 |
| Provider Name | Olakunle A Adenugba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780397190 PECOS PAC ID: 1355709296 Enrollment ID: I20230623003121 |
| Provider Name | Vida Martey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265198162 PECOS PAC ID: 6507224490 Enrollment ID: I20230626001084 |
| Provider Name | Tahani Alqassem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487819991 PECOS PAC ID: 5890049340 Enrollment ID: I20230626002413 |
| Provider Name | Michael Murray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952356768 PECOS PAC ID: 5991856270 Enrollment ID: I20230628003574 |
| Provider Name | Thomas Lavie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972690006 PECOS PAC ID: 5698783876 Enrollment ID: I20230725004138 |
| Provider Name | Philip Polychroniou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487117743 PECOS PAC ID: 0749698942 Enrollment ID: I20230803003846 |
| Provider Name | Joseph E Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255004099 PECOS PAC ID: 0547636524 Enrollment ID: I20230816000094 |
| Provider Name | Allyson J Kemp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063948776 PECOS PAC ID: 3870866734 Enrollment ID: I20230828001641 |
| Provider Name | Stefanie L Alexander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407319601 PECOS PAC ID: 2466816640 Enrollment ID: I20230907001701 |
| Provider Name | Sharon W Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952094237 PECOS PAC ID: 8022472117 Enrollment ID: I20230907002508 |
| Provider Name | Damon A Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538846027 PECOS PAC ID: 6002270725 Enrollment ID: I20230914000827 |
| Provider Name | Ilana R Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104198522 PECOS PAC ID: 2769602986 Enrollment ID: I20231019002939 |
| Provider Name | Elena Alberti Michelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376220954 PECOS PAC ID: 2466809363 Enrollment ID: I20231115000965 |
| Provider Name | Lakeshia M Gilbert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689049835 PECOS PAC ID: 3476902834 Enrollment ID: I20231211001064 |
| Provider Name | Monica Mae Beeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306574876 PECOS PAC ID: 9931543964 Enrollment ID: I20240219001091 |
| Provider Name | Anna Kostrzewsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629536511 PECOS PAC ID: 6901290691 Enrollment ID: I20240220003129 |
| Provider Name | Marcelle Yvonne Kendrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053187898 PECOS PAC ID: 6406290220 Enrollment ID: I20240221000115 |
| Provider Name | Kira Greer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871268029 PECOS PAC ID: 1658715370 Enrollment ID: I20240221000498 |
| Provider Name | Frank Copeli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780181636 PECOS PAC ID: 2769875400 Enrollment ID: I20240312001281 |
| Provider Name | Ahmed Fayed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407240344 PECOS PAC ID: 5294167177 Enrollment ID: I20240401002933 |
| Provider Name | Rachel Pittell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770362535 PECOS PAC ID: 3274971148 Enrollment ID: I20240411000326 |
| Provider Name | Allison Rosales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255816765 PECOS PAC ID: 0446699854 Enrollment ID: I20240418001618 |
| Provider Name | Jennifer Kimmel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619533825 PECOS PAC ID: 3476992587 Enrollment ID: I20240422001555 |
| Provider Name | Stephanie Ikwueme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164141305 PECOS PAC ID: 3870933013 Enrollment ID: I20240503003241 |
Trinity Healthcare Services Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4701 Belair Rd, Baltimore, MD 21206 Phone: 410-325-1850 | |
Michael B. Freedman Phd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6006 Park Heights Ave, Baltimore, MD 21215 Phone: 410-790-8433 Fax: 443-501-3379 | |
Sankofa Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Key Hwy, Unit 442, Baltimore, MD 21230 Phone: 301-758-3682 | |
Home Free Iop Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 W Madison St Ste 11, Baltimore, MD 21201 Phone: 443-438-5239 | |
All Walks Of Life, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 E 25th St, Baltimore, MD 21218 Phone: 410-558-0019 | |
Devaughn Intervention Teach And Treat Options Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4804 York Rd Ste 2, Baltimore, MD 21212 Phone: 443-873-8958 Fax: 443-873-8959 | |
Darryl M Coleman Md Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 N Monroe St, Baltimore, MD 21223 Phone: 443-708-4391 Fax: 443-708-4436 |