Northern Lakes Community Mental Health Authority - Medicare in Traverse City, MI

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Northern Lakes Community Mental Health Authority is a medicare enrolled "Community/behavioral Health" provider in Traverse City, Michigan. Their current practice location is 105 Hall Street, Suite A, Traverse City, Michigan. You can reach out to their office (for appointments etc.) via phone at (231) 922-4850.

Northern Lakes Community Mental Health Authority is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Northern Lakes Community Mental Health Authority is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1518068071.

Contact Information

Northern Lakes Community Mental Health Authority
105 Hall Street, Suite A,
Traverse City, MI 49684
(231) 922-4850
(231) 935-3856

Map and Direction




Healthcare Provider's Profile

Full NameNorthern Lakes Community Mental Health Authority
TypeFacility
SpecialityCommunity/behavioral Health
Location105 Hall Street, Traverse City, Michigan
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1518068071
  • Provider Enumeration Date: 09/26/2006
  • Last Update Date: 01/04/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8022921154
  • Enrollment ID: O20031106000085

Medical Identifiers

Medical identifiers for Northern Lakes Community Mental Health Authority such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1518068071NPI-NPPES
M007933OtherMITRI CARE CHAMPUS
0260B81097OtherMIBCBSM NON OPC PHYSICIANS
104985OtherMIPREFERRED CHOICES
21 4540048MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist (* (Not Available))Secondary
251S00000XCommunity/behavioral Health (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Northern Lakes Community Mental Health Authority acts as a billing entity for following providers:
Provider NamePaula C Colombo
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1043389273
PECOS PAC ID: 9133033327
Enrollment ID: I20031112000727
Provider NameCurtis Albert Cummins
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1144390980
PECOS PAC ID: 2668386111
Enrollment ID: I20031118000694
Provider NameNeal Fellows
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1558433904
PECOS PAC ID: 1153235668
Enrollment ID: I20031118000941
Provider NameScott Monteith
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1104866227
PECOS PAC ID: 4789598152
Enrollment ID: I20031119000083
Provider NameCara Eliza Brinzeiu
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1447274725
PECOS PAC ID: 7214933969
Enrollment ID: I20061019000632
Provider NameKelley A Mahar
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1568494722
PECOS PAC ID: 7911043989
Enrollment ID: I20091005000529
Provider NameRachel H Plum
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1447480934
PECOS PAC ID: 3375786288
Enrollment ID: I20130826000035
Provider NameDavita Burkhead Weiner
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1164650396
PECOS PAC ID: 4284940503
Enrollment ID: I20150901003412
Provider NameElizabeth Ot Gyr
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1891289799
PECOS PAC ID: 9638410434
Enrollment ID: I20190404000248
Provider NameMary Beth Kyro
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1881932499
PECOS PAC ID: 8921340191
Enrollment ID: I20190509000062
Provider NameJennifer Rostamabadi-cook
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1851831713
PECOS PAC ID: 1153656244
Enrollment ID: I20190711001789
Provider NameJacob Robert Aubry
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1326539776
PECOS PAC ID: 1456724939
Enrollment ID: I20230303000165
Provider NameAmy Leigh Humrichouser
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1205332871
PECOS PAC ID: 4880959899
Enrollment ID: I20231012003375
Provider NameAmanda Zuker
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1467933325
PECOS PAC ID: 5395184659
Enrollment ID: I20240418004058

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Northern Lakes Community Mental Health Authority is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Northern Lakes Community Mental Health Authority
105 Hall Street, Suite A,
Traverse City, MI 49684

Ph: (231) 922-4850		Northern Lakes Community Mental Health Authority
105 Hall Street, Suite A,
Traverse City, MI 49684

Ph: (231) 922-4850

Reviews and Comments



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