| Southern Indiana Mental Health And Guidance Center Of Eci | |
|
460 Spring St Jeffersonville IN 47130 | |
| (812) 280-2080 | |
| (812) 206-1243 |
| Full Name | Southern Indiana Mental Health And Guidance Center Of Eci |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 460 Spring St, Jeffersonville, Indiana |
| Authorized Official Name and Position | Shirley A Roll (ENROLLMENT) |
| Authorized Official Contact | 3174727396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Indiana Mental Health And Guidance Center Of Eci 460 Spring St Jeffersonville IN 47130-3452 Ph: (812) 280-2080 | Southern Indiana Mental Health And Guidance Center Of Eci 460 Spring St Jeffersonville IN 47130 Ph: (812) 280-2080 |
| NPI Number | 1851489942 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 06/11/2018 |
| Medicare PECOS PAC ID | 5294624508 |
|---|---|
| Medicare Enrollment ID | O20040315000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851489942 | NPI | - | NPPES |
| 100074520 | Medicaid | IN | |
| 100425950 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 402 (Indiana) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Gregory T Pfister |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639176563 PECOS PAC ID: 3173410255 Enrollment ID: I20040303000210 |
| Provider Name | Denise L Epperson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851440267 PECOS PAC ID: 6608864400 Enrollment ID: I20040501000472 |
| Provider Name | Asad Ismail |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144227026 PECOS PAC ID: 7214926195 Enrollment ID: I20040506001422 |
| Provider Name | Julia K Hyland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235129719 PECOS PAC ID: 5395721633 Enrollment ID: I20040628000023 |
| Provider Name | Eric D Jaggers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902954357 PECOS PAC ID: 4486695392 Enrollment ID: I20050519001139 |
| Provider Name | Agnes Capili Bacala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205891744 PECOS PAC ID: 7517971419 Enrollment ID: I20060131000220 |
| Provider Name | Elizabeth A Grant |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1780744698 PECOS PAC ID: 3274630082 Enrollment ID: I20070511000537 |
| Provider Name | Jessica B Dennison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437209194 PECOS PAC ID: 0345341517 Enrollment ID: I20080409000200 |
| Provider Name | John L Eckard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083603187 PECOS PAC ID: 6406906098 Enrollment ID: I20090602000212 |
| Provider Name | Deborah D Kercheval |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316045768 PECOS PAC ID: 6204950074 Enrollment ID: I20100831000492 |
| Provider Name | Teodoro E.f. Bordador |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750358313 PECOS PAC ID: 0244419885 Enrollment ID: I20110127000884 |
| Provider Name | Mary L Bouldin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467512566 PECOS PAC ID: 9133308711 Enrollment ID: I20110128000083 |
| Provider Name | Leah G Dickerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235291238 PECOS PAC ID: 6204015886 Enrollment ID: I20110128000117 |
| Provider Name | Cathy A Tao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306907688 PECOS PAC ID: 1850301680 Enrollment ID: I20110210000672 |
| Provider Name | Dost Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609987833 PECOS PAC ID: 9133399165 Enrollment ID: I20110831000704 |
| Provider Name | Timothy L Knight |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790775500 PECOS PAC ID: 9537331848 Enrollment ID: I20111011000139 |
| Provider Name | Cindy J Pasinski Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427332477 PECOS PAC ID: 1052584950 Enrollment ID: I20120202000191 |
| Provider Name | Errin L M Weisman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235425299 PECOS PAC ID: 3072768217 Enrollment ID: I20130423000309 |
| Provider Name | Amanda S Davis-houchen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538396155 PECOS PAC ID: 0244479236 Enrollment ID: I20130624000657 |
| Provider Name | Dorothy Renee Clerici |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205277654 PECOS PAC ID: 4981838620 Enrollment ID: I20131011000047 |
| Provider Name | Brett V Hurm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265743868 PECOS PAC ID: 0143456251 Enrollment ID: I20131120000857 |
| Provider Name | Megan Teives Bierman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831528405 PECOS PAC ID: 6608004809 Enrollment ID: I20140115001415 |
| Provider Name | Roberta D Kilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609203082 PECOS PAC ID: 5395973408 Enrollment ID: I20140117001462 |
| Provider Name | Mehreen Mansoor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093857955 PECOS PAC ID: 4688899008 Enrollment ID: I20140627000345 |
| Provider Name | Amy R Whistler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942683016 PECOS PAC ID: 7214240480 Enrollment ID: I20150716001845 |
| Provider Name | Melissa A Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851794374 PECOS PAC ID: 1153643903 Enrollment ID: I20151013000057 |
| Provider Name | Lynnetta Loveland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598163602 PECOS PAC ID: 4880984004 Enrollment ID: I20160531002390 |
| Provider Name | Jalyn M Goolsby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750838066 PECOS PAC ID: 3375830300 Enrollment ID: I20161118000770 |
| Provider Name | Kayla Teives |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124565239 PECOS PAC ID: 8022392455 Enrollment ID: I20170303001011 |
| Provider Name | Jordan R Kirchgessner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942679063 PECOS PAC ID: 2567770977 Enrollment ID: I20170308001413 |
| Provider Name | Steven Robert Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831626894 PECOS PAC ID: 3375813637 Enrollment ID: I20170719000754 |
| Provider Name | Ronald Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649333899 PECOS PAC ID: 0244405371 Enrollment ID: I20171116001819 |
| Provider Name | Leigha Christine Bowyer Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710483037 PECOS PAC ID: 6204190853 Enrollment ID: I20180507001048 |
| Provider Name | Leslie Scott Leach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326319930 PECOS PAC ID: 7012274954 Enrollment ID: I20190220000579 |
| Provider Name | Carissa A Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972095230 PECOS PAC ID: 2062753742 Enrollment ID: I20190405001240 |
| Provider Name | Shannon Kathleen Witt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841673753 PECOS PAC ID: 3971800129 Enrollment ID: I20190605001460 |
| Provider Name | Paul Francis Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841852118 PECOS PAC ID: 2264760719 Enrollment ID: I20190822001445 |
| Provider Name | Sara Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043861735 PECOS PAC ID: 3577995513 Enrollment ID: I20191113002741 |
| Provider Name | Kevin Duane Pollert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114119492 PECOS PAC ID: 8729408273 Enrollment ID: I20201021002873 |
| Provider Name | Joann Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407456601 PECOS PAC ID: 5890108328 Enrollment ID: I20201230001528 |
| Provider Name | Whitney Lyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780124065 PECOS PAC ID: 7113331133 Enrollment ID: I20210202001488 |
| Provider Name | Anthony Aemmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659974806 PECOS PAC ID: 9931513967 Enrollment ID: I20210202001965 |
| Provider Name | Katelyn Rose Mcnulty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720694706 PECOS PAC ID: 3779990262 Enrollment ID: I20210330000775 |
| Provider Name | Daniel Tucker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548316797 PECOS PAC ID: 9931197944 Enrollment ID: I20210506000901 |
| Provider Name | Karona R Yarbrough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437739877 PECOS PAC ID: 6305255035 Enrollment ID: I20210511000783 |
| Provider Name | Lucinda Emily Woodward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962975417 PECOS PAC ID: 1052717808 Enrollment ID: I20210902002399 |
| Provider Name | Sara Beth Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154094373 PECOS PAC ID: 7012314644 Enrollment ID: I20210924001833 |
| Provider Name | Victoria Anne Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174285233 PECOS PAC ID: 8022416551 Enrollment ID: I20211029000559 |
| Provider Name | Heather Mott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568707370 PECOS PAC ID: 8022245604 Enrollment ID: I20211110001016 |
| Provider Name | Heather Crites |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497314231 PECOS PAC ID: 0345570537 Enrollment ID: I20211221001217 |
| Provider Name | Marlowe Michelle Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558014407 PECOS PAC ID: 3476940339 Enrollment ID: I20220422001031 |
| Provider Name | Elizabeth Ann Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720685100 PECOS PAC ID: 9335529031 Enrollment ID: I20220729000510 |
| Provider Name | Sydney Layne Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558081521 PECOS PAC ID: 5294111845 Enrollment ID: I20221005000376 |
| Provider Name | Ercilia A Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326121377 PECOS PAC ID: 4082637269 Enrollment ID: I20221021000837 |
| Provider Name | Carol Jo Nance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063138436 PECOS PAC ID: 1254708340 Enrollment ID: I20221102001383 |
| Provider Name | J W Frank Van Der Palen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275837668 PECOS PAC ID: 1456728112 Enrollment ID: I20221109001395 |
| Provider Name | Kayla Rae Cannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972000198 PECOS PAC ID: 7517334279 Enrollment ID: I20221109001518 |
| Provider Name | Elizabeth Walden-fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730744525 PECOS PAC ID: 4385015403 Enrollment ID: I20230126003113 |
| Provider Name | Kayla Lynch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700434206 PECOS PAC ID: 1557732583 Enrollment ID: I20230130000855 |
| Provider Name | Meredith A Kendell-dunlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588968978 PECOS PAC ID: 0446623656 Enrollment ID: I20230308001099 |
| Provider Name | Cheryl Garman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134538481 PECOS PAC ID: 5294953154 Enrollment ID: I20230310001888 |
| Provider Name | Rachel Mccarty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164079125 PECOS PAC ID: 9234504184 Enrollment ID: I20230407000668 |
| Provider Name | Brandon Lee Mcclanahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790267334 PECOS PAC ID: 1355716135 Enrollment ID: I20230410000181 |
| Provider Name | Tiffany Mayette Degree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841905155 PECOS PAC ID: 9638533219 Enrollment ID: I20230914003772 |
Lifespring, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Spring St, Jeffersonville, IN 47130 Phone: 812-280-2080 | |
Park View Psychiatric Services, Psc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 510 Spring St, Jeffersonville, IN 47130 Phone: 812-282-1888 Fax: 812-218-9318 | |
Family & Children's Place, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 W Court Ave, Suite 102, Jeffersonville, IN 47130 Phone: 502-893-3900 Fax: 502-893-9646 | |
Aster Springs Jeffersonville Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Town Center Blvd, Jeffersonville, IN 47130 Phone: 812-484-1828 Fax: 812-315-3250 | |
Lake Substance Abuse Solutions Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1507 Spring St, Jeffersonville, IN 47130 Phone: 833-525-3727 | |
Wellstone Regional Hospital Acquisition Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2700 Vissing Park Rd, Jeffersonville, IN 47130 Phone: 812-284-8000 Fax: 812-258-2023 | |
Banigala Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2780 Jefferson Centre Way Unit 104, Jeffersonville, IN 47130 Phone: 812-913-0913 Fax: 502-805-0690 |