| South Community Inc. | |
|
3095 Kettering Blvd Moraine OH 45439 | |
| (937) 293-8300 | |
| (937) 534-1353 |
| Full Name | South Community Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3095 Kettering Blvd, Moraine, Ohio |
| Authorized Official Name and Position | Carol M. Smerz (CEO) |
| Authorized Official Contact | 9372938300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Community Inc. 3095 Kettering Blvd Moraine OH 45439 Ph: (937) 293-8300 | South Community Inc. 3095 Kettering Blvd Moraine OH 45439 Ph: (937) 293-8300 |
| NPI Number | 1427289818 |
|---|---|
| Provider Enumeration Date | 08/03/2009 |
| Last Update Date | 04/30/2012 |
| Medicare PECOS PAC ID | 7315971066 |
|---|---|
| Medicare Enrollment ID | O20050921001092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427289818 | NPI | - | NPPES |
| 0200295 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0101 (Ohio) | Primary |
| Provider Name | Susan Kay Songer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033276597 PECOS PAC ID: 3476504267 Enrollment ID: I20050209000631 |
| Provider Name | Christina G Weston |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104883016 PECOS PAC ID: 2567414923 Enrollment ID: I20050214000529 |
| Provider Name | Rick T Bowers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396784450 PECOS PAC ID: 5496789141 Enrollment ID: I20060619000200 |
| Provider Name | Nancy Fitch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669586343 PECOS PAC ID: 9436157450 Enrollment ID: I20061129000120 |
| Provider Name | Anna M Espy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235291212 PECOS PAC ID: 7810068814 Enrollment ID: I20080619000046 |
| Provider Name | Adrienne Y Mccray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518003417 PECOS PAC ID: 4284759259 Enrollment ID: I20100914000735 |
| Provider Name | Kristina Wills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326382292 PECOS PAC ID: 7113240243 Enrollment ID: I20141222002190 |
| Provider Name | Emily Freimuth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639550981 PECOS PAC ID: 3870802556 Enrollment ID: I20151020001476 |
| Provider Name | Cari Morton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215488473 PECOS PAC ID: 6204112758 Enrollment ID: I20170417001934 |
| Provider Name | Jacqueline Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639423098 PECOS PAC ID: 4789960121 Enrollment ID: I20170419000727 |
| Provider Name | Anita Koerner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942554746 PECOS PAC ID: 4688951809 Enrollment ID: I20170425003054 |
| Provider Name | Julie Hood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386818896 PECOS PAC ID: 6901183326 Enrollment ID: I20170511001407 |
| Provider Name | Ashley Leblanc |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215298989 PECOS PAC ID: 0143507442 Enrollment ID: I20170512002186 |
| Provider Name | Scott Alan Beidelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083988893 PECOS PAC ID: 9436423373 Enrollment ID: I20170915002949 |
| Provider Name | Kelsie Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578123691 PECOS PAC ID: 6800227091 Enrollment ID: I20200501001577 |
| Provider Name | Jamey Leigh Hepner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376853325 PECOS PAC ID: 0042637258 Enrollment ID: I20200902003014 |
| Provider Name | Elizabeth G Liapis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003350380 PECOS PAC ID: 0446678528 Enrollment ID: I20200922002855 |
| Provider Name | Jennifer L Roll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912376708 PECOS PAC ID: 5799104980 Enrollment ID: I20201008000708 |
| Provider Name | Ciara Nicole Blake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215413968 PECOS PAC ID: 9436562626 Enrollment ID: I20210107001044 |
| Provider Name | Pamela M Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053908384 PECOS PAC ID: 9537576335 Enrollment ID: I20210323001210 |
| Provider Name | Jenna J Branam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083229751 PECOS PAC ID: 2466860366 Enrollment ID: I20210414000162 |
| Provider Name | Donna J Stites |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780123570 PECOS PAC ID: 6204244080 Enrollment ID: I20210415001213 |
| Provider Name | Kristina S Fisher |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1265777460 PECOS PAC ID: 0446650303 Enrollment ID: I20210614003325 |
| 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 | Danielle Nicole Seward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366939639 PECOS PAC ID: 7517364367 Enrollment ID: I20210922000848 |
| Provider Name | Aisha N Brothers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376089474 PECOS PAC ID: 1951678754 Enrollment ID: I20220107000004 |
| Provider Name | Carrie Maria Stephenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891340428 PECOS PAC ID: 2062808314 Enrollment ID: I20220413001646 |
| Provider Name | Barbara Lynn Crabill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528312212 PECOS PAC ID: 6709220593 Enrollment ID: I20240220003884 |
| Provider Name | Kathryn Lauren Banks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427541879 PECOS PAC ID: 7315381068 Enrollment ID: I20240221001408 |
| Provider Name | Parthina N Christon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730553595 PECOS PAC ID: 0749624427 Enrollment ID: I20240221002264 |
| Provider Name | Sarah E Rhodes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447801238 PECOS PAC ID: 9335583012 Enrollment ID: I20240221002429 |
| Provider Name | Jordan L Umphrey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245883388 PECOS PAC ID: 1153765854 Enrollment ID: I20240221002832 |
| Provider Name | Kathleen M Hendrickson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891932851 PECOS PAC ID: 4082058698 Enrollment ID: I20240221003581 |
| Provider Name | David Flynn Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154674703 PECOS PAC ID: 9234573841 Enrollment ID: I20240221003661 |
| Provider Name | Thelma L Chandler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104997063 PECOS PAC ID: 8921442534 Enrollment ID: I20240221003825 |
| Provider Name | Tellea Renee Tinkham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417454539 PECOS PAC ID: 2769826387 Enrollment ID: I20240221004219 |
| Provider Name | Elizabeth A Roode |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679827489 PECOS PAC ID: 0648617571 Enrollment ID: I20240327000611 |
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Premier Health Specialists Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3170 Kettering Blvd, Building B 3rd Floor, Moraine, OH 45439 Phone: 937-991-3188 Fax: 937-223-9811 | |
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The Change Agency Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2400 W Stroop Rd, Moraine, OH 45439 Phone: 937-315-0030 Fax: 937-701-6901 | |
Recovery Services Of Greater Dayton Llp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3430 S Dixie Dr Ste 308, Moraine, OH 45439 Phone: 937-388-3009 | |
Project Cure Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Daruma Pkwy, Moraine, OH 45439 Phone: 937-262-3500 Fax: 937-496-5283 | |
Pyramid Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3055 Kettering Blvd Ste 101, Moraine, OH 45439 Phone: 937-446-6046 |