| Sunrise Psychological Services Llc | |
|
25 Royal Crest Dr Prospect CT 06712-1486 | |
| (845) 826-0060 | |
| Not Available |
| Full Name | Sunrise Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 25 Royal Crest Dr, Prospect, Connecticut |
| Authorized Official Name and Position | Joel Meisels (PRESIDENT) |
| Authorized Official Contact | 8458260060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Psychological Services Llc Po Box 1250 Monsey NY 10952-8349 Ph: () - | Sunrise Psychological Services Llc 25 Royal Crest Dr Prospect CT 06712-1486 Ph: (845) 826-0060 |
| NPI Number | 1699199869 |
|---|---|
| Provider Enumeration Date | 02/09/2014 |
| Last Update Date | 02/09/2014 |
| Medicare PECOS PAC ID | 7911130216 |
|---|---|
| Medicare Enrollment ID | O20140512000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699199869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Lisa Haut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962400150 PECOS PAC ID: 5496732737 Enrollment ID: I20040702001207 |
| Provider Name | Gail S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053374009 PECOS PAC ID: 2264499169 Enrollment ID: I20041213000458 |
| Provider Name | Jay K Berkowitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255382396 PECOS PAC ID: 4688622319 Enrollment ID: I20050110000231 |
| Provider Name | Gloria Losada-zarate |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144401886 PECOS PAC ID: 8123075421 Enrollment ID: I20050407000771 |
| Provider Name | Sheri S Kipperman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952496671 PECOS PAC ID: 3870530959 Enrollment ID: I20050411000506 |
| Provider Name | Elysa M Doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386621266 PECOS PAC ID: 1951347822 Enrollment ID: I20050630000445 |
| Provider Name | Susan C Feldman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134197684 PECOS PAC ID: 2769492321 Enrollment ID: I20060426000602 |
| Provider Name | Judith K Davidson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154377984 PECOS PAC ID: 0244239622 Enrollment ID: I20061212000647 |
| Provider Name | Andrew B Pleshkevich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891833729 PECOS PAC ID: 5890898902 Enrollment ID: I20070310000004 |
| Provider Name | Joann S Sloan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639220544 PECOS PAC ID: 6709989411 Enrollment ID: I20070319000396 |
| Provider Name | Margaret Garrison |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1790974376 PECOS PAC ID: 1557441730 Enrollment ID: I20080204000329 |
| Provider Name | Lemlem Egziabher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255592739 PECOS PAC ID: 7517030745 Enrollment ID: I20080722000406 |
| Provider Name | Osman Qureshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942408265 PECOS PAC ID: 4082774286 Enrollment ID: I20081118000446 |
| Provider Name | Audra R Beauregard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710133806 PECOS PAC ID: 3173683083 Enrollment ID: I20081122000099 |
| Provider Name | Carissa A Tufano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760639819 PECOS PAC ID: 1850452087 Enrollment ID: I20081206000101 |
| Provider Name | Maria R Sangiorgio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063412237 PECOS PAC ID: 9638075260 Enrollment ID: I20081215000653 |
| Provider Name | Paul A Furino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902065931 PECOS PAC ID: 2062575236 Enrollment ID: I20090114000335 |
| Provider Name | Melissa M Masse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851625271 PECOS PAC ID: 5496880312 Enrollment ID: I20100317000807 |
| Provider Name | Lashanda B Harvey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831327816 PECOS PAC ID: 3870788573 Enrollment ID: I20101108000822 |
| Provider Name | Wendy S Garvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285950907 PECOS PAC ID: 8325227341 Enrollment ID: I20110124000603 |
| Provider Name | Catherine Macrae |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073769105 PECOS PAC ID: 9335318930 Enrollment ID: I20110817000195 |
| Provider Name | Shelley Berman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073894697 PECOS PAC ID: 9537330832 Enrollment ID: I20110917000013 |
| Provider Name | Ann-marie S Meacham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447429204 PECOS PAC ID: 1850559766 Enrollment ID: I20120223000597 |
| Provider Name | Michele M Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962794891 PECOS PAC ID: 4082874235 Enrollment ID: I20120326000138 |
| Provider Name | Patricia L Almeida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437428141 PECOS PAC ID: 2567622731 Enrollment ID: I20120326000428 |
| Provider Name | Tracie Preli-derwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497014344 PECOS PAC ID: 8426213000 Enrollment ID: I20120705000221 |
| Provider Name | Jorge Aguilar Zanatta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477704971 PECOS PAC ID: 9335396969 Enrollment ID: I20120904000257 |
| Provider Name | Maryfrances L Desteno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922374354 PECOS PAC ID: 9436308087 Enrollment ID: I20120926000125 |
| Provider Name | Erin E Mccormack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265681241 PECOS PAC ID: 4486895190 Enrollment ID: I20130723000391 |
| Provider Name | Batya Beth Levitan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518395318 PECOS PAC ID: 5294961843 Enrollment ID: I20131204000541 |
| Provider Name | Deborah S Guidetti Gerwien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821420563 PECOS PAC ID: 3173751492 Enrollment ID: I20140114000317 |
| Provider Name | Sheila A Bridges-woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003198094 PECOS PAC ID: 5698906337 Enrollment ID: I20140324000476 |
| Provider Name | Wanda Serrano-miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184715922 PECOS PAC ID: 1850514613 Enrollment ID: I20140523000144 |
| Provider Name | John T Dukes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861699068 PECOS PAC ID: 4183840689 Enrollment ID: I20140718000199 |
| Provider Name | Thomas Martin Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023274495 PECOS PAC ID: 7113148503 Enrollment ID: I20141029000079 |
| Provider Name | Sebrina Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235530395 PECOS PAC ID: 5092037432 Enrollment ID: I20141215000085 |
| Provider Name | Patrick Brew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265846927 PECOS PAC ID: 9931422458 Enrollment ID: I20150108000168 |
| Provider Name | Juleen Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700284106 PECOS PAC ID: 4183940133 Enrollment ID: I20150310000931 |
| Provider Name | Rachel Sampson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316077795 PECOS PAC ID: 4587981592 Enrollment ID: I20150331001201 |
| Provider Name | Sarah Bione-dunn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356579395 PECOS PAC ID: 9032438171 Enrollment ID: I20150512001267 |
| Provider Name | Norris Haynes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598907156 PECOS PAC ID: 5496061152 Enrollment ID: I20150826002192 |
| Provider Name | Ellen Marie Galat |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093725848 PECOS PAC ID: 8224347885 Enrollment ID: I20151021002007 |
| Provider Name | Kelley Machado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417328634 PECOS PAC ID: 8921308941 Enrollment ID: I20151124000944 |
| Provider Name | Tulie P Brew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114398385 PECOS PAC ID: 7911059969 Enrollment ID: I20160223001948 |
| Provider Name | Fredo J Clermont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649641150 PECOS PAC ID: 6002112455 Enrollment ID: I20160310000901 |
| Provider Name | Carolyn A Croce-mirque |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053754374 PECOS PAC ID: 2668699471 Enrollment ID: I20160811001760 |
| Provider Name | Stephane Pady Clermont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508237199 PECOS PAC ID: 7113212762 Enrollment ID: I20160823000159 |
| Provider Name | Melissa A Hurley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629357553 PECOS PAC ID: 9931489051 Enrollment ID: I20161207001676 |
| Provider Name | Lora Small |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437554730 PECOS PAC ID: 9830470376 Enrollment ID: I20161221001557 |
| Provider Name | Eva Torres Maldonado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164881736 PECOS PAC ID: 9032491022 Enrollment ID: I20170127000594 |
| Provider Name | Lisa M Navarra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386977890 PECOS PAC ID: 5193863397 Enrollment ID: I20170207001078 |
| Provider Name | Karolina Dudzik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649713926 PECOS PAC ID: 6608150099 Enrollment ID: I20170302002142 |
| Provider Name | Angela Hay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891235198 PECOS PAC ID: 9638454085 Enrollment ID: I20170327000846 |
| Provider Name | Ellen Louise Sollazzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821464017 PECOS PAC ID: 1052619574 Enrollment ID: I20170328001847 |
| Provider Name | Verona Sonia Gordon Khouri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164957809 PECOS PAC ID: 9234406711 Enrollment ID: I20170605001940 |
| Provider Name | Cassandra Shepard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740718618 PECOS PAC ID: 9436422508 Enrollment ID: I20170912001926 |
| Provider Name | Amanda Surace Hanko |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538673223 PECOS PAC ID: 7719245620 Enrollment ID: I20171226001882 |
| Provider Name | Melissa K Sweeney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194133819 PECOS PAC ID: 8426313826 Enrollment ID: I20180606002187 |
| Provider Name | Karen Tocher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942484803 PECOS PAC ID: 7113272758 Enrollment ID: I20180621002578 |
| Provider Name | Zenna E Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639668221 PECOS PAC ID: 8628324787 Enrollment ID: I20180702002773 |
| Provider Name | Helen Ruth Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336630797 PECOS PAC ID: 4082960828 Enrollment ID: I20180709001918 |
| Provider Name | Michelle Wojciechowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336649649 PECOS PAC ID: 8628327210 Enrollment ID: I20180815000162 |
| Provider Name | Cathleen R Codding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477030633 PECOS PAC ID: 2163771502 Enrollment ID: I20180820000591 |
| Provider Name | Susan Marie Blayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225172281 PECOS PAC ID: 0143570432 Enrollment ID: I20180907000343 |
| Provider Name | Debra Susan Turkat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730463605 PECOS PAC ID: 7719141092 Enrollment ID: I20180911000020 |
| Provider Name | Christine Leah Shapter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821138389 PECOS PAC ID: 3971854795 Enrollment ID: I20180918002563 |
| Provider Name | Lilliam Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821375213 PECOS PAC ID: 3678836640 Enrollment ID: I20180920003242 |
| Provider Name | Bryna Lynn Pauker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609067370 PECOS PAC ID: 4082967963 Enrollment ID: I20181023000327 |
| Provider Name | Tierra Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063811529 PECOS PAC ID: 3173879004 Enrollment ID: I20181107002350 |
| Provider Name | Suzanne Viger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760957526 PECOS PAC ID: 8628322278 Enrollment ID: I20181116001661 |
| Provider Name | Samantha M Hague |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134522592 PECOS PAC ID: 0648524140 Enrollment ID: I20181120001883 |
| Provider Name | Joanne M. Iurato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558422410 PECOS PAC ID: 3173877677 Enrollment ID: I20181120002011 |
| Provider Name | Angela Marie Virella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124505714 PECOS PAC ID: 3476898958 Enrollment ID: I20190103000903 |
| Provider Name | Ablan Berko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053749812 PECOS PAC ID: 9739317363 Enrollment ID: I20190114002298 |
| Provider Name | Kimberly A Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083923353 PECOS PAC ID: 4981892551 Enrollment ID: I20190122003040 |
| Provider Name | Kate Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801350079 PECOS PAC ID: 4082952205 Enrollment ID: I20190214000547 |
| Provider Name | Keisha Clayton-fearon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891240776 PECOS PAC ID: 7517205446 Enrollment ID: I20190219000396 |
| Provider Name | Kevin Joseph Dobi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679687743 PECOS PAC ID: 5890796692 Enrollment ID: I20190306000774 |
| Provider Name | Jennifer D'eugenio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891282356 PECOS PAC ID: 3577802644 Enrollment ID: I20190307000865 |
| Provider Name | Coreen Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558717256 PECOS PAC ID: 3375882442 Enrollment ID: I20190307000956 |
| Provider Name | Hannah Schacht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265807887 PECOS PAC ID: 5799024865 Enrollment ID: I20190307001152 |
| Provider Name | Erin H Mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689181554 PECOS PAC ID: 8022357052 Enrollment ID: I20190308000762 |
| Provider Name | Andrew James Matusiak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801331640 PECOS PAC ID: 9638419542 Enrollment ID: I20190312002536 |
| Provider Name | Helena Owusu Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477010288 PECOS PAC ID: 2365782919 Enrollment ID: I20190319002221 |
| Provider Name | Rebecca D. Addai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134686827 PECOS PAC ID: 7911248679 Enrollment ID: I20190405000555 |
| Provider Name | Erin Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083171995 PECOS PAC ID: 0446591028 Enrollment ID: I20190409000148 |
| Provider Name | Donalda Isidore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407317670 PECOS PAC ID: 2163763624 Enrollment ID: I20190410000414 |
| Provider Name | Thamara Sterling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407311988 PECOS PAC ID: 6305189119 Enrollment ID: I20190520000263 |
| Provider Name | Trudy Tamara Pearson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235621236 PECOS PAC ID: 4385987809 Enrollment ID: I20190523001517 |
| Provider Name | Stefanie Laccone Thach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902140890 PECOS PAC ID: 2365785854 Enrollment ID: I20190524001804 |
| Provider Name | Holly Marie Cortella |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265854467 PECOS PAC ID: 4981970282 Enrollment ID: I20190611000417 |
| Provider Name | Megan Melrose Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235694621 PECOS PAC ID: 1052645389 Enrollment ID: I20190620001438 |
| Provider Name | Michele A Wiggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801458716 PECOS PAC ID: 8022343888 Enrollment ID: I20190716001988 |
| Provider Name | Karen Ann Thorpe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710544036 PECOS PAC ID: 7517292253 Enrollment ID: I20190717001838 |
| Provider Name | Kimberly A Gagnon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831741388 PECOS PAC ID: 4385970474 Enrollment ID: I20190726002152 |
| Provider Name | Renesha L Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750549853 PECOS PAC ID: 9638408289 Enrollment ID: I20190909000732 |
| Provider Name | Christine Ann Nucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386204238 PECOS PAC ID: 5395074348 Enrollment ID: I20190917001243 |
| Provider Name | Katelyn Mary Cifone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689221731 PECOS PAC ID: 8022348861 Enrollment ID: I20190923000337 |
| Provider Name | Stephanie Benjamin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578980538 PECOS PAC ID: 7416295670 Enrollment ID: I20191003000827 |
| Provider Name | Akiva Schmookler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033574785 PECOS PAC ID: 7517207863 Enrollment ID: I20191108000620 |
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