Kim Ann Fatato, LMSW | |
4539 Pinefield Ave, Portage, MI 49024-3021 | |
(269) 209-2491 | |
Not Available |
Full Name | Kim Ann Fatato |
---|---|
Gender | Female |
Speciality | Clinical Social Worker |
Experience | 22 Years |
Location | 4539 Pinefield Ave, Portage, Michigan |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477764660 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6801087444 (Michigan) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Pine Rest Christian Mental Health Services | 4981506508 | 314 |
Entity Name | Pine Rest Christian Mental Health Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922019157 PECOS PAC ID: 4981506508 Enrollment ID: O20040123000787 |
Mailing Address | Practice Location Address |
---|---|
Kim Ann Fatato, LMSW 4539 Pinefield Ave, Portage, MI 49024-3021 Ph: (269) 209-2491 | Kim Ann Fatato, LMSW 4539 Pinefield Ave, Portage, MI 49024-3021 Ph: (269) 209-2491 |
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