GERIATRIC PSYCHIATRIC SERVICES PLLC (NPI# 1467492173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467492173 |
| Entity Type | Organization |
| Organization Name | GERIATRIC PSYCHIATRIC SERVICES PLLC |
| Practice Address |
1715 Indian Wood Cir Ste 200 Maumee OH 43537-4055 |
| Mailing Address |
28800 Ryan Rd Suite 320 Warren MI 48092-4269 |
| Practice Telephone | 8779069699 |
| Mailing Telephone | (586) 620-8100 |
| Mailing Fax Number | 8662277418 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | ROBERT A CLEMENTE (MANAGER) |
| Authorized Official Telephone | 5866208100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS PHYSICIAN GROUP | 260F340040 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 28800 Ryan Rd, Suite 320, Warren, MI 480924269 | 5866208100 | 8662277418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235465659 | Geriatric Psychiatric Services Pllc | Psychologist | 2024 Adderbury Ln, Madison, WI 53711-4002 | 2009-10-20 |
| 1124273826 | Geriatric Psychiatric Services Pllc | Psychiatry & Neurology | 1 Westbrook Corp Ctr, Suite 300, Westchester, IL 60154-5701 | 2008-11-21 |
| 1306172788 | Geriatric Psychiatric Services Pllc | Nursing Facility/Intermediate Care Facility | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-10-20 |
| 1891935144 | Geriatric Psychiatric Services Pllc | Nurse Practitioner | 9465 Counselors Row, Suite 200, Indianapolis, IN 46240-6423 | 2009-02-26 |
| 1528208873 | Geriatric Psychiatric Services Pllc | Social Worker | 1721 Moon Lake Blvd, Hoffman Estates, IL 60169-1069 | 2009-02-26 |
| 1073753323 | Geriatric Psychiatric Services Pllc | Psychologist | 9465 Counselors Row, Suite 200, Indianapolis, IN 46240-6423 | 2009-02-26 |
| 1881834125 | Geriatric Psychiatric Services Pllc | Psychiatry & Neurology | 9465 Counselors Row, Suite 200, Indianapolis, IN 46240-6423 | 2009-02-26 |
| 1801035902 | Geriatric Psychiatric Services Pllc | Psychiatry & Neurology | 363 W Big Beaver Rd, Suite 200, Troy, MI 48084-5220 | 2009-02-12 |
| 1538308630 | Geriatric Psychiatric Services Pllc | Psychologist | 1 Westbrook Corporate Ctr, Suite 300, Westchester, IL 60154-5701 | 2009-02-12 |
| 1730328832 | Geriatric Psychiatric Services Pllc | Nurse Practitioner | 1 Westbrook Corporate Ctr, Suite 300, Westchester, IL 60154-5701 | 2009-02-12 |
| Street Address |
1715 INDIAN WOOD CIR STE 200 |
| City | MAUMEE |
| State | OH |
| Zip Code | 43537-4055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619584687 | Debra A Wilkins | Home Health | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2020-09-24 |
| 1124641394 | Kyle Wilson Wallace | Registered Nurse | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2020-05-22 |
| 1316598816 | Aloha Nutrition and Wellness | Dietitian, Registered | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2019-09-25 |
| 1114486628 | Jeffrey Kistler Lpcc LLC | Counselor | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2019-03-14 |
| 1821562216 | Amanda Vanhorne | Counselor | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2019-01-18 |
| 1366914954 | Stephanie Heinlein | Dietitian, Registered | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537 | 2018-12-20 |
| 1326558313 | Monique Chatman | Technician | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2017-10-04 |
| 1104271196 | Lionrock Behavioral Health, Inc. | Community/Behavioral Health | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2016-04-27 |
| 1518240571 | Tiffany L Brown | Nurse Practitioner | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2011-09-26 |
| 1366756330 | Regional Physician Services of Ohio PC | Nurse Practitioner | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2010-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245884709 | Mary Walasinski | Behavior Technician | 1900 Indian Wood Circle Suite 100, Maumee, OH 43537 | 2019-08-01 |
| 1912483314 | Integrated Restorative Solutions LLC | Pain Medicine | 2718 River Rd, Maumee, OH 43537 | 2018-07-18 |
| 1326533373 | Michelle Lei Sandwisch | Nurse Practitioner | 7140 Maumee Western Road, Maumee, OH 43537 | 2018-06-22 |
| 1669978201 | Bradley D Walker | Case Manager/Care Coordinator | 1600 Michigan Ave, Maumee, OH 43537 | 2018-04-03 |
| 1841792306 | Stephen Flory | Specialist/Technologist | 2584 S Detroit Ave, Maumee, OH 43537 | 2018-03-01 |
| 1851841787 | Michelle Laver | Social Worker | 7320 Sh 108, Wauseon, OH 43537 | 2016-10-04 |
| 1083070288 | Friends Who Care | Home Health | 2749 Pine Trace Dr, Maumee, OH 43537 | 2016-01-05 |
| 1386025203 | Unique Health Care Solutions, LLC | Home Health | 3430 Briarfield Blvd, Maumee, OH 43537 | 2015-06-16 |
| 1104239698 | Jill Saul | Dietitian, Registered | 5871 Monclova Rd., Maumee, OH 43537 | 2014-06-03 |
| 1922438910 | Kristen Junga | Counselor | 1627 Henthorne Dr Ste E, Maumee, OH 43537 | 2013-11-12 |
| Find all providers in zip 43537 | ||||
| Taxonomy Code | 103TA0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Adult Development & Aging |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831756667 | Makia Rayford | Psychologist | 3460 Stalling Ct, Columbus, OH 43204-5204 | 2019-05-28 |
| 1609431725 | Diane Lynn Rehklau | Psychologist | 215 Park Ave, Montpelier, OH 43543-2016 | 2019-05-03 |
| 1114409513 | Jerema E Holliday | Psychologist | 5969 E Livingston Ave Ste 100, Columbus, OH 43232-2907 | 2018-08-31 |
| 1245721745 | Ebony D Ladson | Psychologist | 86 Fatima Dr, Campbell, OH 44405-1902 | 2018-05-21 |
| 1093906752 | Clare Anne Gideon | Psychologist | 5844 Lotusdale Dr, Parma Heights, OH 44130-2105 | 2007-08-07 |
| 1174615561 | Stella Y. Hshieh | Psychologist | 1724 Bruce St, Canal Fulton, OH 44614-9313 | 2006-09-29 |
| 1427087667 | Carol A Bline | Psychologist | 2386 Parkview Dr, Grove City, OH 43123-1858 | 2006-07-01 |
| 1760479612 | Paula E Hartman-stein | Psychologist | 265 W Main St, Suite 102, Kent, OH 44240-2461 | 2005-10-05 |
| 1407490295 | Samantha Denise Lebo | Psychologist | 3640 Colonel Glenn Hwy, Dayton, OH 45435-0002 | 2019-11-05 |
| 1891348405 | Beach Glass Psychology LLC | Psychologist | 26965 Center Ridge Rd, Westlake, OH 44145-4044 | 2019-07-23 |
| 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.