Mr Russell W Dern, PHD | |
975 Kingsivew Drive, Bldg A, Lebanon, OH 45036-9562 | |
(513) 228-7800 | |
(513) 228-7846 |
Full Name | Mr Russell W Dern |
---|---|
Gender | Male |
Speciality | Clinical Psychologist |
Experience | 42 Years |
Location | 975 Kingsivew Drive, Lebanon, Ohio |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568438497 | NPI | - | NPPES |
11489916 | Other | OH | CAQH |
0630884 | Medicaid | OH | |
000000012343 | Other | OH | ANTHEM PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 3444 (Ohio) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Community Mental Health Centers Of Warren County, Inc | 0446155337 | 9 |
Entity Name | Community Mental Health Centers Of Warren County, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740278381 PECOS PAC ID: 0446155337 Enrollment ID: O20031204000135 |
Mailing Address | Practice Location Address |
---|---|
Mr Russell W Dern, PHD 204 Cook Rd, Suite 400, Lebanon, OH 45036-9600 Ph: (513) 228-7800 | Mr Russell W Dern, PHD 975 Kingsivew Drive, Bldg A, Lebanon, OH 45036-9562 Ph: (513) 228-7800 |
Mrs. Sarah Kinnison, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 700 Holbrook Ave, Lebanon, OH 45036 Phone: 513-934-5383 | |
Dr. Paul J Walker Sr., PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5787 St Route 63, Lebanon, OH 45036 Phone: 513-932-3388 Fax: 513-934-2901 | |
Dr. Annette Marie Kosmac, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1879 Deerfield Rd, Lebanon, OH 45036 Phone: 513-695-2900 | |
Elizabeth Paige Sebastian, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 759 Columbus Ave, Lebanon, OH 45036 Phone: 513-932-4337 | |
Elizaabeth Osborn, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1297 Weathervane Way, Lebanon, OH 45036 Phone: 513-519-6611 | |
Dr. Cynthia Miner, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 307 E Silver St, Lebanon, OH 45036 Phone: 513-934-0370 Fax: 513-934-4302 |