INTERCARE COMMUNITY HEALTH NETWORK (NPI# 1205349990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205349990 |
| Entity Type | Organization |
| Organization Name | INTERCARE COMMUNITY HEALTH NETWORK |
| Practice Address |
5498 109th Ave Pullman MI 49450-9631 |
| Mailing Address |
50 Industrial Park Rd Bangor MI 49013-1246 |
| Practice Telephone | 8558696900 |
| Practice Fax Number | 2692360505 |
| Mailing Telephone | 2694277937 |
| Mailing Fax Number | 2694275180 |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2017-11-16 |
| Authorized Official Name | VELMA HENDERSHOTT (CEO/PRESIDENT) |
| Authorized Official Telephone | 2694277937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336701119 | Intercare Community Health Network | Counselor | 7450 Hochberger Rd Rm 15a, Eau Claire, MI 49111-9762 | 2019-07-02 |
| 1205363033 | Intercare Community Health Network | Clinic/Center | 796 Highway M-139, Benton Harbor, MI 49022-3881 | 2017-05-11 |
| 1891113353 | Intercare Community Health Network | Obstetrics & Gynecology | 50 Indusstrial Park Road, Bangor, MI 49013-1246 | 2014-04-02 |
| 1306064720 | Intercare Community Health Network | Clinic/Center | 540 South State Street, Sparta, MI 49345 | 2007-04-23 |
| 1699808881 | Intercare Community Health Network | Clinic/Center | 6270 W Main Street, Eau Claire, MI 49111 | 2007-03-14 |
| 1992818835 | Intercare Community Health Network | Clinic/Center | 308 Charles St, Bangor, MI 49013 | 2006-08-16 |
| 1326058512 | Intercare Community Health Network | Clinic/Center | 50 Industrial Park Dr, Bangor, MI 49013 | 2006-08-09 |
| 1902235328 | Intercare Community Health Network | Clinic/Center | 1485 M 139, Benton Harbor, MI 49022-5711 | 2013-11-06 |
| 1225334063 | Intercare Community Health Network | Clinic/Center | 5498 109th Ave, Pullman, MI 49450-9631 | 2011-01-26 |
| 1558506253 | Intercare Community Health Network | Clinic/Center | 870 Colfax Ave, Benton Harbor, MI 49022-7409 | 2008-12-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INTERCARE COMMUNITY HEALTH NETWORK | 50 Industrial Park Rd, Bangor, MI 49013-1246 |
| Street Address |
5498 109TH AVE |
| City | PULLMAN |
| State | MI |
| Zip Code | 49450-9631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710918883 | Renee K Hibma | Nurse Practitioner | 5498 109th Ave, Pullman, MI 49450 | 2006-07-06 |
| 1184030736 | Alejandra Kovac | Physician Assistant | 5498 109th Ave, Pullman, MI 49450-9631 | 2014-07-03 |
| 1184963639 | Carol Ann Mcbratnie | Nurse Practitioner | 5498 109th Ave, Pullman, MI 49450-9631 | 2013-02-04 |
| 1225334063 | Intercare Community Health Network | Clinic/Center | 5498 109th Ave, Pullman, MI 49450-9631 | 2011-01-26 |
| 1457361677 | Intercare Community Health Network | Clinic/Center | 5498 109th Ave, Pullman, MI 49450 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871529040 | Dean Alcorn | Dental Hygienist | 5498 109th Avenue, Pullman, MI 49450 | 2006-06-22 |
| 1134156029 | Kenneth Hite | Physician Assistant | 5498 109th Avenue, Pullman, MI 49450 | 2006-06-27 |
| 1831316306 | William T Parks IIi | Dentist | 5498 109th Avenue, Pullman, MI 49450-9631 | 2007-04-19 |
| 1174922439 | Teresa Marin | Rehabilitation Practitioner | 825 56th St, Pullman, MI 49450-9738 | 2014-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265049902 | Erin L Rose | Specialist/Technologist | 510 Nw Larry St, Pullman, WA 99163-3584 | 2020-09-27 |
| 1164039079 | Jalyn Rutledge | Specialist/Technologist | Bohler Athletic Complex Cougar Way - Wsu, Pullman, WA 99164-0001 | 2020-09-24 |
| 1851902605 | Northwest Clinical Services | Family Medicine | 825 Se Bishop Blvd Ste 301c, Pullman, WA 99163-5517 | 2020-08-14 |
| 1154949733 | Washington State University | Clinical Medical Laboratory | Bustad Hall Room 155n, Pullman, WA 99164-0001 | 2020-07-09 |
| 1669097127 | Dawnmd LLC | Family Medicine | 540 E Main St Ste A, Pullman, WA 99163-2660 | 2020-06-10 |
| 1801418504 | Savannah Horning | Specialist/Technologist | Bohler Athletic Complex Room M4, Pullman, WA 99164-0001 | 2020-05-15 |
| 1003445255 | Jennifer Beattie | Specialist/Technologist | 1360 Cougar Way, Pullman, WA 99163 | 2020-04-08 |
| 1114555133 | Lilly Paige Walker | Physical Medicine & Rehabilitation | 1624 Ne Cougar Way, Perham 126, Pullman, WA 99163-9916 | 2020-03-27 |
| 1689200099 | Tyler David Sykes | Dentist | 650 Se Bishop Blvd Ste 200, Pullman, WA 99163-5966 | 2020-03-17 |
| 1922632967 | Carlie Jean Lubbesmeyer | Specialist/Technologist | 1815 Wilson Road, Pullman, WA 99163-9916 | 2020-02-28 |
| Find all providers in PULLMAN | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629364062 | Brenda Kay Deal Bye | Psychiatry & Neurology | Washington State University 1125 Se Washington St, Pullman, WA 99164 | 2011-06-23 |
| 1598795486 | Alan S Unis | Psychiatry & Neurology | 840 Se Bishop Blvd, Suite 203, Pullman, WA 99163-5502 | 2006-07-04 |
| 1952375925 | Becky J Conley | Psychiatry & Neurology | 340 Ne Maple St, Pullman, WA 99163-4120 | 2006-02-15 |
| 1689647703 | Bruce R Wright | Psychiatry & Neurology | 825 Se Bishop Blvd, 401, Pullman, WA 99163-5517 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686165 | Centia Health LLC | Psychiatry & Neurology | 23802 Wintergreen Cir, Novi, MI 48374-3681 | 2020-10-16 |
| 1114524428 | Clarity Behavioral Health Pllc | Psychiatry & Neurology | 7154 Merrybrook, West Bloomfield, MI 48322-4066 | 2020-10-08 |
| 1790395978 | Amiri Psychiatric Services Pllc | Psychiatry & Neurology | 1695 W Saratoga St, Ferndale, MI 48220-3153 | 2020-08-03 |
| 1881211191 | Infinite Wellness Healthcare, Pllc | Psychiatry & Neurology | 19855 Outer Dr Ste 504e, Dearborn, MI 48124-2040 | 2020-07-02 |
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1083247134 | Actify Neurotherapies, Pllc | Psychiatry & Neurology | 28475 Greenfield Rd Ste 113, Southfield, MI 48076-3034 | 2020-02-18 |
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1922646538 | Sylvia Hanson Md Pllc | Psychiatry & Neurology | 6461 Golden Ln, West Bloomfield, MI 48322-3096 | 2019-12-13 |
| 1740823129 | Tms Wellness Clinic of Michigan Pllc | Psychiatry & Neurology | 5757 W Maple Rd Ste 800-b, West Bloomfield, MI 48322-2277 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.