Bethany Moulton, MS, LLPC | |
46972 Bartlett Dr, Canton, MI 48187-1409 | |
(734) 709-8422 | |
Not Available |
Full Name | Bethany Moulton |
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Gender | Female |
Speciality | Counselor |
Location | 46972 Bartlett Dr, Canton, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801373568 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Entity Name | Heron Ridge Associates Plc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013187541 PECOS PAC ID: 2961303573 Enrollment ID: O20040116000532 |
Entity Name | Optum Behavioral Care Of Colorado, P.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306616735 PECOS PAC ID: 0941648463 Enrollment ID: O20240412001576 |
Mailing Address | Practice Location Address |
---|---|
Bethany Moulton, MS, LLPC 46972 Bartlett Dr, Canton, MI 48187-1409 Ph: (734) 709-8422 | Bethany Moulton, MS, LLPC 46972 Bartlett Dr, Canton, MI 48187-1409 Ph: (734) 709-8422 |
Mr. Nathaniel Edison Ponder, CADC, CTP-C Counselor Medicare: Not Enrolled in Medicare Practice Location: 50430 School House Rd, Canton, MI 48187 Phone: 734-495-1722 | |
Mary Blackmon, CPRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50430 School House Rd, Canton, MI 48187 Phone: 734-431-2357 | |
Michelle Fitzhugh, Counselor Medicare: Medicare Enrolled Practice Location: 1685 Christopher Dr, Canton, MI 48188 Phone: 734-664-5016 | |
Evelyn Colleen Conklin, MS-RN Counselor Medicare: Not Enrolled in Medicare Practice Location: 43835 Brandywyne Rd, Canton, MI 48187 Phone: 734-459-8991 | |
Mr. Tyler Manns, Counselor Medicare: Not Enrolled in Medicare Practice Location: 43825 Michigan Ave, Canton, MI 48188 Phone: 734-397-3088 | |
Kerry Anne Minshew, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 42283 Highgate Ct, Canton, MI 48187 Phone: 734-981-9081 Fax: 734-981-9081 | |
Cecelia Salamone, Counselor Medicare: Not Enrolled in Medicare Practice Location: 47329 Ashley Ct, Canton, MI 48187 Phone: 734-576-2220 |