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2005 Ashland Ave Toledo OH 43620-1703 | |
| (419) 841-7701 | |
| (419) 841-1691 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2005 Ashland Ave, Toledo, Ohio |
| Authorized Official Name and Position | Adam J Nutt (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 4198417701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6605 West Central Avenue Toledo OH 43617-1000 Ph: (419) 841-7701 | 2005 Ashland Ave Toledo OH 43620-1703 Ph: (419) 841-7701 |
| NPI Number | 1215947809 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 03/13/2017 |
| Medicare PECOS PAC ID | 5395639215 |
|---|---|
| Medicare Enrollment ID | O20040211000960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215947809 | NPI | - | NPPES |
| 0202060 | Medicaid | OH | |
| 2480739 | Medicaid | OH |
| Provider Name | Kim M Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902845175 PECOS PAC ID: 4385548205 Enrollment ID: I20031121000825 |
| Provider Name | Suzanne Frances Brodbeck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518053818 PECOS PAC ID: 9830163443 Enrollment ID: I20040820000243 |
| Provider Name | Mahdi Doumet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801880471 PECOS PAC ID: 1557319266 Enrollment ID: I20050120000601 |
| Provider Name | Khalida Durrani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750386173 PECOS PAC ID: 6709976509 Enrollment ID: I20071217000743 |
| Provider Name | Barbara J Laforrest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144246703 PECOS PAC ID: 4789753583 Enrollment ID: I20080520000483 |
| Provider Name | Bushra Haneef Qureishi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396969416 PECOS PAC ID: 9537251087 Enrollment ID: I20090608000449 |
| Provider Name | Wissam K Hoteit |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265673990 PECOS PAC ID: 7012063480 Enrollment ID: I20090928000025 |
| Provider Name | Angela P Best |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073654877 PECOS PAC ID: 3577699552 Enrollment ID: I20100329001096 |
| Provider Name | Charlotte L Easterling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558481234 PECOS PAC ID: 0749311371 Enrollment ID: I20100625000909 |
| Provider Name | Reka C Monus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942596796 PECOS PAC ID: 5890963003 Enrollment ID: I20110713000858 |
| Provider Name | Maria I Kostrzewski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629067814 PECOS PAC ID: 6507030376 Enrollment ID: I20111114000725 |
| Provider Name | Chandani Marie Lewis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851534390 PECOS PAC ID: 2769623891 Enrollment ID: I20130801000041 |
| Provider Name | Katharine Elizabeth Beach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437397163 PECOS PAC ID: 4880816701 Enrollment ID: I20141110001234 |
| Provider Name | Prentis L Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063784973 PECOS PAC ID: 5092026237 Enrollment ID: I20150615002370 |
| Provider Name | Michael Bryant Thompson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457490849 PECOS PAC ID: 6901955210 Enrollment ID: I20150828002346 |
| Provider Name | Marisa S Wojcik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902895105 PECOS PAC ID: 0345557013 Enrollment ID: I20150911001666 |
| Provider Name | Heather Polaski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053665372 PECOS PAC ID: 8022311596 Enrollment ID: I20160119000111 |
| Provider Name | Vanessa Grace P Penaranda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205271988 PECOS PAC ID: 8325345978 Enrollment ID: I20160616000853 |
| Provider Name | Alyse N Stolting |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407275514 PECOS PAC ID: 6709183379 Enrollment ID: I20170807001370 |
| Provider Name | Laura Anglim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316476476 PECOS PAC ID: 8921374935 Enrollment ID: I20171018003301 |
| Provider Name | Katherine Rose Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982114799 PECOS PAC ID: 3375805120 Enrollment ID: I20180315000837 |
| Provider Name | Elizabeth Sue Tyson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629581434 PECOS PAC ID: 5597004051 Enrollment ID: I20190227001150 |
| Provider Name | Karen D. Yanico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639258031 PECOS PAC ID: 2860729076 Enrollment ID: I20190812000843 |
| Provider Name | Shazia J Naqvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932596780 PECOS PAC ID: 9739486481 Enrollment ID: I20190918002479 |
| Provider Name | Hannah Harms Mickael |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639581242 PECOS PAC ID: 2264764422 Enrollment ID: I20191022000585 |
| Provider Name | Courtney Lauren Savel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972021657 PECOS PAC ID: 4688906621 Enrollment ID: I20191024001795 |
| Provider Name | Juanita Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184062671 PECOS PAC ID: 4587094388 Enrollment ID: I20200420003263 |
| Provider Name | Adam Wilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093324394 PECOS PAC ID: 2567889835 Enrollment ID: I20200901001683 |
| Provider Name | Joshua James Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356939045 PECOS PAC ID: 3971917782 Enrollment ID: I20210205000527 |
| Provider Name | Thomas Khamfoo Roach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003313768 PECOS PAC ID: 9335497155 Enrollment ID: I20210707003381 |
| Provider Name | Whitney S Dillard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235510116 PECOS PAC ID: 3779986849 Enrollment ID: I20210727002404 |
| Provider Name | Jason Mcallister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053851758 PECOS PAC ID: 1355746975 Enrollment ID: I20210819003631 |
| Provider Name | Erin E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588910467 PECOS PAC ID: 5698163632 Enrollment ID: I20211025002770 |
| Provider Name | Mary Schmidt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326636309 PECOS PAC ID: 9830588649 Enrollment ID: I20211117001599 |
| Provider Name | Domenic Joseph Cancilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487318713 PECOS PAC ID: 1658760368 Enrollment ID: I20211118002725 |
| Provider Name | John Michael Byrne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407360506 PECOS PAC ID: 0244621993 Enrollment ID: I20220106002543 |
| Provider Name | Branden Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295254373 PECOS PAC ID: 4880078468 Enrollment ID: I20220831000788 |
| Provider Name | Esmeralda Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063141026 PECOS PAC ID: 3971988767 Enrollment ID: I20220914003046 |
| Provider Name | Tyler P Snyder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396365532 PECOS PAC ID: 2567887706 Enrollment ID: I20220926000950 |
| Provider Name | Cale Charles Streeter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639733678 PECOS PAC ID: 6204160351 Enrollment ID: I20230807002740 |
| Provider Name | Joseph N Kamel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750910188 PECOS PAC ID: 5799100962 Enrollment ID: I20230815003798 |
| Provider Name | Riann Tippett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104333186 PECOS PAC ID: 5193197804 Enrollment ID: I20231108003555 |
| Provider Name | Birinder M Mann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548755317 PECOS PAC ID: 0244688257 Enrollment ID: I20231201001552 |
| Provider Name | Megan Bishop |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912419870 PECOS PAC ID: 6507218617 Enrollment ID: I20240113000463 |
| Provider Name | Leah Marty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124500962 PECOS PAC ID: 4082066949 Enrollment ID: I20240117001252 |
| Provider Name | Susan K Alex |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346574704 PECOS PAC ID: 2668824475 Enrollment ID: I20240117002883 |
| Provider Name | Renee Radford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033490826 PECOS PAC ID: 9739531559 Enrollment ID: I20240117003300 |
| Provider Name | Amy Nicolazzo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528196730 PECOS PAC ID: 6406208669 Enrollment ID: I20240123004499 |
| Provider Name | Claudia Mary Patterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174889265 PECOS PAC ID: 3577916345 Enrollment ID: I20240129000697 |
| Provider Name | Megan Aja Bullen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427361021 PECOS PAC ID: 1850744491 Enrollment ID: I20240130002643 |
| Provider Name | Megan Marie Poliquin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760965123 PECOS PAC ID: 0547613861 Enrollment ID: I20240201004120 |
| Provider Name | Leslie Jo Lefevre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013278266 PECOS PAC ID: 2163875485 Enrollment ID: I20240201004195 |
| Provider Name | Christine A Bohland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629318910 PECOS PAC ID: 2567806912 Enrollment ID: I20240214000795 |
| Provider Name | Donna Rae Yenderusiak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972931483 PECOS PAC ID: 9739525890 Enrollment ID: I20240311003960 |
| Provider Name | Jennifer Metzger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043630999 PECOS PAC ID: 4183060247 Enrollment ID: I20240311004014 |
| Provider Name | Kristin Bruce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235529777 PECOS PAC ID: 5294171187 Enrollment ID: I20240314000350 |
| Provider Name | Pamela J Kummerer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235530668 PECOS PAC ID: 0648580399 Enrollment ID: I20240321000111 |
| Provider Name | Walter C Wehenkel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316219652 PECOS PAC ID: 9234571621 Enrollment ID: I20240530003412 |
| Provider Name | Kayla Spradley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558005959 PECOS PAC ID: 0648651042 Enrollment ID: I20240910003351 |
| Provider Name | Garrett W Spradley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457096109 PECOS PAC ID: 1557742954 Enrollment ID: I20240916001393 |
| Provider Name | Lesley Bittner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487988630 PECOS PAC ID: 9234505017 Enrollment ID: I20241022001685 |
| Provider Name | Caroline Corey Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467792879 PECOS PAC ID: 1355876764 Enrollment ID: I20241121004344 |
| Provider Name | Kaylee Finch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134609928 PECOS PAC ID: 1759816960 Enrollment ID: I20241125003732 |
Larry E Hamme Ph.d Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4125 Monroe St, Toledo, OH 43606 Phone: 419-472-7330 Fax: 419-472-8675 | |
Thera Med Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6500 W Central Ave # D-2, Toledo, OH 43617 Phone: 419-841-2298 Fax: 419-841-7245 | |
Water Blue Therapy Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3443 146th St, Toledo, OH 43611 Phone: 419-217-2122 | |
Revitalized Behavioral Healthcare, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5577 Airport Hwy Ste 102, Toledo, OH 43615 Phone: 419-215-5831 | |
Reflections Coaching, Counseling, And Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2475 Collingwood Blvd Ste 110, Toledo, OH 43620 Phone: 419-944-5469 | |
Personal Growth Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1946 N 13th St Ste 427, Toledo, OH 43604 Phone: 888-746-0756 |