| Supportive Care Of Maryland Llc | |
|
4409 E West Hwy Riverdale MD 20737-1058 | |
| (718) 298-4375 | |
| Not Available |
| Full Name | Supportive Care Of Maryland Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4409 E West Hwy, Riverdale, Maryland |
| Authorized Official Name and Position | Raphael Lichtschein (OWNERR) |
| Authorized Official Contact | 7185061115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Care Of Maryland Llc 27 Randolph Rd Howell NJ 07731-8611 Ph: (718) 298-4375 | Supportive Care Of Maryland Llc 4409 E West Hwy Riverdale MD 20737-1058 Ph: (718) 298-4375 |
| NPI Number | 1447802616 |
|---|---|
| Provider Enumeration Date | 07/09/2019 |
| Last Update Date | 07/09/2019 |
| Medicare PECOS PAC ID | 9234460999 |
|---|---|
| Medicare Enrollment ID | O20191010000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447802616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Annette Sarcinelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891806733 PECOS PAC ID: 1052357787 Enrollment ID: I20050705000496 |
| Provider Name | Colleen Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972925477 PECOS PAC ID: 1557585395 Enrollment ID: I20140617001416 |
| Provider Name | Sabra Donna Starnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518354695 PECOS PAC ID: 7618276734 Enrollment ID: I20160425000802 |
| Provider Name | Angela S Gilbert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649414673 PECOS PAC ID: 4183905151 Enrollment ID: I20170105001395 |
| Provider Name | Ebony N Calloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467987974 PECOS PAC ID: 5294002549 Enrollment ID: I20201112000225 |
| Provider Name | Judy Versola Russo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912274937 PECOS PAC ID: 9739593252 Enrollment ID: I20210126000912 |
| Provider Name | Ibrahim Iftoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730772369 PECOS PAC ID: 7810306206 Enrollment ID: I20210517000143 |
| Provider Name | Jenelle Anthony |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841447596 PECOS PAC ID: 1557591336 Enrollment ID: I20220301002911 |
| Provider Name | Nadine Mcleod Peterkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548663826 PECOS PAC ID: 8527445303 Enrollment ID: I20220601003128 |
| Provider Name | Krystal Marie Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124770953 PECOS PAC ID: 8325426257 Enrollment ID: I20220607001130 |
| Provider Name | Amy R Luckenbill-wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053654889 PECOS PAC ID: 0547648057 Enrollment ID: I20220614001653 |
| Provider Name | Brenda Eneke Eno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083972970 PECOS PAC ID: 3678953486 Enrollment ID: I20220711000091 |
| Provider Name | Erin M Shaffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477084325 PECOS PAC ID: 2163794835 Enrollment ID: I20220711002359 |
| Provider Name | Frederick Gilbert Medinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215357918 PECOS PAC ID: 7012280555 Enrollment ID: I20220713000581 |
| Provider Name | Archelle Nicole Bowen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144878505 PECOS PAC ID: 2365824406 Enrollment ID: I20220805000392 |
| Provider Name | Angel Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245983154 PECOS PAC ID: 6507248630 Enrollment ID: I20220805002867 |
| Provider Name | Veronica Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962935684 PECOS PAC ID: 0244583474 Enrollment ID: I20220817000651 |
| Provider Name | Jartu Nylander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376138131 PECOS PAC ID: 2567846595 Enrollment ID: I20220825001060 |
| Provider Name | Paula Simone Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427718725 PECOS PAC ID: 9032505300 Enrollment ID: I20220912000025 |
| Provider Name | Aryn L Rosner Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457767014 PECOS PAC ID: 3375764053 Enrollment ID: I20220912001124 |
| Provider Name | Yared Tekle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922755354 PECOS PAC ID: 4981080017 Enrollment ID: I20221018003430 |
| Provider Name | Sheena Althea Lyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396297875 PECOS PAC ID: 1951701499 Enrollment ID: I20221205001811 |
| Provider Name | Solange Fechwi Adangwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891051025 PECOS PAC ID: 4587032438 Enrollment ID: I20221206000253 |
| Provider Name | Monica M Ngwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912646738 PECOS PAC ID: 2163899907 Enrollment ID: I20221208000356 |
| Provider Name | Jerome K Obiagba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558012427 PECOS PAC ID: 1850776329 Enrollment ID: I20221208001278 |
| Provider Name | Charity A Dzieketey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841708849 PECOS PAC ID: 8123497559 Enrollment ID: I20221209001544 |
| Provider Name | Erica Featherson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245713726 PECOS PAC ID: 1153792650 Enrollment ID: I20230120000031 |
| Provider Name | Syreeta Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821609629 PECOS PAC ID: 7911378815 Enrollment ID: I20230131002118 |
| Provider Name | Dominic Mabeya Omwenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275161408 PECOS PAC ID: 9335552843 Enrollment ID: I20230228000069 |
| Provider Name | Mutinta Chestnut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427320159 PECOS PAC ID: 7618332362 Enrollment ID: I20230502001088 |
| Provider Name | Charlesa P Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932764024 PECOS PAC ID: 1658737473 Enrollment ID: I20230522002081 |
| Provider Name | Selam Tekie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720411432 PECOS PAC ID: 2163889627 Enrollment ID: I20230530000692 |
| Provider Name | Teresa Faye Crenshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336895184 PECOS PAC ID: 0345608857 Enrollment ID: I20230615000835 |
| Provider Name | Kathleen Marie Eiseman-brock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841983160 PECOS PAC ID: 8224497979 Enrollment ID: I20230629000193 |
| Provider Name | Lydia Emuobosa Opara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558955054 PECOS PAC ID: 9436554649 Enrollment ID: I20230724001456 |
| Provider Name | Carol M Asplen- Masden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164007373 PECOS PAC ID: 4284015553 Enrollment ID: I20230809000000 |
| Provider Name | Marci L Drimer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225226277 PECOS PAC ID: 3779872304 Enrollment ID: I20230809001579 |
| Provider Name | Stephanie S Boyles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255099156 PECOS PAC ID: 3870956741 Enrollment ID: I20230824002337 |
| Provider Name | Niraj Thakarshi Chapla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659508067 PECOS PAC ID: 9133345291 Enrollment ID: I20230825003469 |
| Provider Name | Sharon Sonko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194116152 PECOS PAC ID: 7810350527 Enrollment ID: I20230829001601 |
| Provider Name | Alisha K Holben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003516006 PECOS PAC ID: 8729447933 Enrollment ID: I20230901000377 |
| Provider Name | Joyce K. Slater |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366599276 PECOS PAC ID: 0446613483 Enrollment ID: I20230911004193 |
| Provider Name | Shane O'hare |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194268276 PECOS PAC ID: 0749532554 Enrollment ID: I20230913002650 |
| Provider Name | Lianna Bissell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275938128 PECOS PAC ID: 5890141881 Enrollment ID: I20231027000388 |
| Provider Name | Savinien Siewe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124719380 PECOS PAC ID: 0941656748 Enrollment ID: I20231031001962 |
| Provider Name | Sindhu Kodoth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235919523 PECOS PAC ID: 9537516570 Enrollment ID: I20231113002044 |
| Provider Name | Wendy M Puglisi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447426218 PECOS PAC ID: 2860840154 Enrollment ID: I20231128000035 |
| Provider Name | Dorothy Estella Adamson Holley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285791335 PECOS PAC ID: 1557384930 Enrollment ID: I20231129002569 |
| Provider Name | Manju T Jose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023885373 PECOS PAC ID: 5698125029 Enrollment ID: I20231228000552 |
| Provider Name | James S Weima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891562682 PECOS PAC ID: 6800247123 Enrollment ID: I20240110003692 |
| Provider Name | Shantel Winkfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952948713 PECOS PAC ID: 0941652879 Enrollment ID: I20240123001130 |
| Provider Name | Aziichap B Tung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588295018 PECOS PAC ID: 0446696496 Enrollment ID: I20240312003671 |
| Provider Name | Catherine Nnedi Nwosu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497431985 PECOS PAC ID: 5991141640 Enrollment ID: I20240315002804 |
| Provider Name | Mary Ann Waters-bilbo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457816704 PECOS PAC ID: 3072962174 Enrollment ID: I20240323000076 |
| Provider Name | Teswar Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851904106 PECOS PAC ID: 9234576265 Enrollment ID: I20240326001280 |
| Provider Name | Yetunde O Magadji |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750679619 PECOS PAC ID: 8426496233 Enrollment ID: I20240329000092 |
Inspired Consulting Group, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5600 Taylor Rd, Riverdale, MD 20737 Phone: 301-877-3721 | |
Change Reaction Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4404 Queensbury Rd Ste 105, Riverdale, MD 20737 Phone: 240-432-7659 Fax: 301-864-1301 | |
Guiding Light Therapeutic Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4404 Queensbury Rd Ste 105, Riverdale, MD 20737 Phone: 301-379-4211 | |
Whole Healing Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6200 Baltimore Ave Ste 300, Riverdale, MD 20737 Phone: 301-500-0311 | |
Addvantage Counseling, Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6320 61st Pl, Riverdale, MD 20737 Phone: 202-579-1144 | |
Change Reaction, Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4404 Queensbury Rd Ste 105, Riverdale, MD 20737 Phone: 301-864-0919 Fax: 301-864-1301 |