MEDICARE: ALPENGLOW MENTAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician

General Provider Information

NPI Number	:	1427924398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPENGLOW MENTAL HEALTH

Provider Business Mailing Address
First Line	:	7950 MOORSBRIDGE RD STE 305
Second Line	:
City	:	PORTAGE
State	:	MI
Zip	:	49024-4420
Country	:	US
Telephone Number	:	269-222-2109
Fax Number	:	800-350-5021

Provider Business Practice Location Address
First Line	:	7950 MOORSBRIDGE RD STE 305
Second Line	:
City	:	PORTAGE
State	:	MI
Zip	:	49024-4420
Country	:	US
Telephone Number	:	269-222-2109
Fax Number	:	800-350-5021

Authorized Official
Title or Position	:	PHYSICIAN/PROPRIETOR
Name	:	SUZANNE HUBERTY
Credential	:	MD
Telephone Number	:	269-222-2109

Provider Enumeration Date	:	10/16/2025
Last Update Date	:	12/05/2025

Similar Medicare Providers

1003778697 — ALISON BAILEY YOUNG
Practice Location Address:

1514 ALICE AVE
PORTAGE, MI
49024-1202

Practice Phone: 269-364-8744
Practice Fax:

1942204680 — MICHAEL PARK M.D.
Practice Location Address:

430 W CENTRE AVE
PORTAGE, MI
49024-5304

Practice Phone: 269-321-6673
Practice Fax: 269-324-5594

1396749800 — MS. LUCETTA LYNNE LYFORD PA-C
Practice Location Address:

430 W. CENTRE AVE.
PORTAGE, MI
49024

Practice Phone: 269-321-6673
Practice Fax:

1811994841 — DR. SCOTT DONALD HOLLEY M.D., F.A.C.S.
Practice Location Address:

7971 MOORSBRIDGE RD
PORTAGE, MI
49024-4075

Practice Phone: 269-329-2900
Practice Fax: 269-329-1408

1629075668 — DR. RAGHURAM GOP ELLURU M.D., F.A.C.S.
Practice Location Address:

7971 MOORSBRIDGE RD
PORTAGE, MI
49024-4075

Practice Phone: 269-329-2900
Practice Fax: 269-329-1408

1639177983 — ANN PATRICE SHEEHAN DNP, CPNP
Practice Location Address:

670 MALL DR
PORTAGE, MI
49024-2878

Practice Phone: 269-327-1900
Practice Fax: 269-327-1564

Directions to “ALPENGLOW MENTAL HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.