Spectracare Integrated Services Llc | |
3542 Montgomery Hwy Dothan AL 36303-2165 | |
(334) 712-2720 | |
(334) 712-2727 |
Full Name | Spectracare Integrated Services Llc |
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Speciality | Clinic/Center |
Location | 3542 Montgomery Hwy, Dothan, Alabama |
Authorized Official Name and Position | Melissa Kirkland (CHIEF EXECTUTIVE OFFICER) |
Authorized Official Contact | 3347122720 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Spectracare Integrated Services Llc Po Box 1245 Dothan AL 36302-1245 Ph: (334) 712-2720 | Spectracare Integrated Services Llc 3542 Montgomery Hwy Dothan AL 36303-2165 Ph: (334) 712-2720 |
NPI Number | 1205385176 |
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Provider Enumeration Date | 10/03/2016 |
Last Update Date | 10/03/2016 |
Medicare PECOS PAC ID | 8921386798 |
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Medicare Enrollment ID | O20161028001477 |
Identifier | Type | State | Issuer |
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1205385176 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Fernando Lopez |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1659391951 PECOS PAC ID: 7810980950 Enrollment ID: I20040406000094 |
Provider Name | Esiri Esin |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1013147990 PECOS PAC ID: 4284778259 Enrollment ID: I20100927000264 |
Provider Name | Danielle Lee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679114532 PECOS PAC ID: 0345672838 Enrollment ID: I20191121003154 |
Provider Name | Amanda Louise Baine |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528663275 PECOS PAC ID: 0648685008 Enrollment ID: I20210216003240 |
Provider Name | Bobbi Houston Pippins |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1891485173 PECOS PAC ID: 8628434123 Enrollment ID: I20230524003273 |
Provider Name | Brittnee Beck |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407546021 PECOS PAC ID: 9537527148 Enrollment ID: I20230614000249 |
Provider Name | Jenny Lee Bell |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1811644503 PECOS PAC ID: 8527429349 Enrollment ID: I20230726002626 |
Provider Name | Lisa Colvin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639937840 PECOS PAC ID: 8325488604 Enrollment ID: I20240503000914 |
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Southeast Alabama Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 Ross Clark Cir, Dothan, AL 36301 Phone: 334-793-8111 Fax: 334-793-8147 | |
Life Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 S Foster St, Dothan, AL 36301 Phone: 719-684-6715 | |
Southeast Psychiatric Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2812 Hartford Hwy Ste 1, Dothan, AL 36305 Phone: 334-712-1170 Fax: 334-460-8391 | |
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