Mr Blake Mitchell Gilbert, | |
2611 Woodlawn Rd, Sterling, IL 61081-4151 | |
(815) 625-0013 | |
Not Available |
Full Name | Mr Blake Mitchell Gilbert |
---|---|
Gender | Male |
Speciality | Psychologist |
Location | 2611 Woodlawn Rd, Sterling, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578996567 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 599 (North Dakota) | Primary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
Entity Name | Badlands Human Service Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124072525 PECOS PAC ID: 9739085499 Enrollment ID: O20031211000947 |
Entity Name | Northwest Human Service Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770524613 PECOS PAC ID: 4183683196 Enrollment ID: O20041006000330 |
Entity Name | Southeast Human Service Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932146941 PECOS PAC ID: 8527027556 Enrollment ID: O20041006000512 |
Mailing Address | Practice Location Address |
---|---|
Mr Blake Mitchell Gilbert, 2624 9th Ave S, Fargo, ND 58103-2350 Ph: (701) 298-4500 | Mr Blake Mitchell Gilbert, 2611 Woodlawn Rd, Sterling, IL 61081-4151 Ph: (815) 625-0013 |
Paulette Marie Selmi, Psychologist Medicare: Medicare Enrolled Practice Location: 205 3rd Ave, Sterling, IL 61081 Phone: 815-213-7669 | |
Chad Brownfield, BS MHP Psychologist Medicare: Medicare Enrolled Practice Location: 2611 Woodlawn Rd, Sterling, IL 61081 Phone: 815-625-0013 | |
Mr. Robert Stanley Kuba, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2611 Woodlawn Rd, Sterling, IL 61081 Phone: 815-625-0033 |