Corena Lene Herder, | |
204 Arbor Pointe Dr, Battle Creek, MI 49037-2036 | |
(918) 915-1250 | |
Not Available |
Full Name | Corena Lene Herder |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 204 Arbor Pointe Dr, Battle Creek, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205439858 | NPI | - | NPPES |
6401017571 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 6401017571 (Michigan) | Primary |
Entity Name | Jackson Healing Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629677893 PECOS PAC ID: 0840603031 Enrollment ID: O20210107000916 |
Mailing Address | Practice Location Address |
---|---|
Corena Lene Herder, 204 Arbor Pointe Dr, Battle Creek, MI 49037-2036 Ph: (918) 915-1250 | Corena Lene Herder, 204 Arbor Pointe Dr, Battle Creek, MI 49037-2036 Ph: (918) 915-1250 |
Edwina Wallace, Counselor Medicare: Medicare Enrolled Practice Location: 140 Michigan Ave W, Battle Creek, MI 49017 Phone: 269-966-1460 Fax: 269-966-2844 | |
Ginger Osborn, Counselor Medicare: Medicare Enrolled Practice Location: 4625 Beckley Rd, Battle Creek, MI 49015 Phone: 269-979-8119 | |
Jessica Lea Cuellar, Counselor Medicare: Not Enrolled in Medicare Practice Location: 203 Brigden Dr, Battle Creek, MI 49014 Phone: 269-282-7105 | |
Emily Wilber, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 203 Brigden Dr, Battle Creek, MI 49014 Phone: 269-282-7112 | |
Inyoung Michelle Lee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3630 Capital Ave Sw, Battle Creek, MI 49015 Phone: 269-966-1460 | |
Troy Michael Masengale, Counselor Medicare: Medicare Enrolled Practice Location: 11 Green St, Battle Creek, MI 49014 Phone: 269-965-1148 | |
Amanda Ann-morgan Cope, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 491 Columbia Ave E Ste 4, Battle Creek, MI 49014 Phone: 269-962-9611 Fax: 269-962-9612 |