Candice Ericksen, | |
35054 23 Mile Rd Ste 104, New Baltimore, MI 48047-2019 | |
(586) 863-4000 | |
Not Available |
Full Name | Candice Ericksen |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 35054 23 Mile Rd Ste 104, New Baltimore, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730745266 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 6401222444 (Michigan) | Primary |
Entity Name | Transcendent Bodhi Psychotherapy Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922727973 PECOS PAC ID: 7315387511 Enrollment ID: O20240506001057 |
Mailing Address | Practice Location Address |
---|---|
Candice Ericksen, 8061 21 Mile Rd Ste 2, Shelby Twp, MI 48317-4309 Ph: (586) 943-0028 | Candice Ericksen, 35054 23 Mile Rd Ste 104, New Baltimore, MI 48047-2019 Ph: (586) 863-4000 |
Mr. Reginald Charles Terry, MA, LLPC, CAADC Counselor Medicare: Medicare Enrolled Practice Location: 35031 23 Mile Rd, New Baltimore, MI 48047 Phone: 586-725-5777 Fax: 586-725-4099 | |
Shawn Friday, L.L.P.C Counselor Medicare: Not Enrolled in Medicare Practice Location: 51145 Washington St Ste E, New Baltimore, MI 48047 Phone: 586-604-9101 | |
Allison Johnston, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35218 23 Mile Rd, New Baltimore, MI 48047 Phone: 586-204-6762 | |
Mr. Aaron Curtis Teutsch, MA, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35031 23 Mile Rd., New Baltimore, MI 48047 Phone: 586-330-5233 | |
Kenesha Taylor, Counselor Medicare: Not Enrolled in Medicare Practice Location: 35031 23 Mile Rd, New Baltimore, MI 48047 Phone: 888-837-8993 | |
Mr. Joseph Lawrence Oskin Iii, MA, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35031 23 Mile Rd, New Baltimore, MI 48047 Phone: 248-495-9026 |