Lydia Lorenz, | |
10485 48th Ave Apt A8, Allendale, MI 49401-8485 | |
(810) 730-0653 | |
Not Available |
Full Name | Lydia Lorenz |
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Gender | Female |
Speciality | Counselor |
Location | 10485 48th Ave Apt A8, Allendale, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750835245 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Entity Name | Michigan Modern Psychology Group Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447701255 PECOS PAC ID: 6103162896 Enrollment ID: O20190117001322 |
Mailing Address | Practice Location Address |
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Lydia Lorenz, 10485 48th Ave Apt A8, Allendale, MI 49401-8485 Ph: () - | Lydia Lorenz, 10485 48th Ave Apt A8, Allendale, MI 49401-8485 Ph: (810) 730-0653 |
William Fields, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11092 Island Ct, Allendale, MI 49401 Phone: 810-691-8570 | |
Mrs. Gina Marie Merritt, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 11304 Edgewater Dr, Suite D, Allendale, MI 49401 Phone: 616-892-1070 | |
Mr. Warren N Leemgraven, BS, CAC I Counselor Medicare: Not Enrolled in Medicare Practice Location: 6866 Joal St, Allendale, MI 49401 Phone: 616-895-5486 |