Polly Ann Wilson, LMSW | |
17250 Farmington Rd, Livonia, MI 48152-3151 | |
(734) 425-4070 | |
(734) 425-8350 |
Full Name | Polly Ann Wilson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 17250 Farmington Rd, Livonia, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437594652 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6801117015 (Michigan) | Primary |
Entity Name | Ascension Eastwood Behavioral Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396787701 PECOS PAC ID: 2163324492 Enrollment ID: O20040126000572 |
Entity Name | Detroit Central City Community Mental Health Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285043406 PECOS PAC ID: 3274728829 Enrollment ID: O20101109001334 |
Mailing Address | Practice Location Address |
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Polly Ann Wilson, LMSW 44000 W 12 Mile Rd Ste 101, Novi, MI 48377-2646 Ph: (248) 226-3001 | Polly Ann Wilson, LMSW 17250 Farmington Rd, Livonia, MI 48152-3151 Ph: (734) 425-4070 |
Bushra Tayab, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 37450 Schoolcraft Rd Ste 110, Livonia, MI 48150 Phone: 734-458-4601 Fax: 734-458-4611 | |
Robert Keith Graham, DCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 17940 Farmington Rd, Suite 225, Livonia, MI 48152 Phone: 734-466-3311 | |
Kellie Kroeger, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 19805 Farmington Rd, Livonia, MI 48152 Phone: 586-846-0535 | |
Rebecca L Sherman, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 17250 Farmington Rd, Livonia, MI 48152 Phone: 734-425-4070 Fax: 734-425-8350 | |
Mrs. Amanda Denise Glaze, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 14100 Newburgh Rd, Livonia, MI 48154 Phone: 734-464-7810 | |
Mrs. Cortney Renee Bugar, LLMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 18316 Middlebelt Rd, Livonia, MI 48152 Phone: 248-615-9730 | |
Mr. Adam Beyer, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 36423 Grandon St, Livonia, MI 48150 Phone: 248-613-1514 Fax: 734-284-8702 |