| Miss Lisa Marie Boomers, LLPC | |
|
1215 Fulton St E, Grand Rapids, MI 49503-3849 | |
| (616) 742-0351 | |
| Not Available |
| Full Name | Miss Lisa Marie Boomers |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1215 Fulton St E, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477900819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 6401017408 (Michigan) | Primary |
| Entity Name | Counseling Center Of West Michigan Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437610730 PECOS PAC ID: 9234469255 Enrollment ID: O20190918000332 |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Lisa Marie Boomers, LLPC 1800 W Main St Lot 56, Lowell, MI 49331-1547 Ph: (616) 901-0401 | Miss Lisa Marie Boomers, LLPC 1215 Fulton St E, Grand Rapids, MI 49503-3849 Ph: (616) 742-0351 |
Mrs. Dana Kay Anderson, MA, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 Eastern Ave Ne, Grand Rapids, MI 49503 Phone: 616-254-7741 Fax: 616-254-7750 | |
Marilyn Dale, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5005 Plainfield Ave Ne Ste 100, Grand Rapids, MI 49525 Phone: 616-279-3869 Fax: 616-608-4657 | |
Brittani Shaw, Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 Eastern Ave Ne, Grand Rapids, MI 49503 Phone: 616-818-4803 Fax: 616-710-5176 | |
Tao Chance Brown-edwards, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 68th St Se, Grand Rapids, MI 49548 Phone: 616-455-5000 | |
Lauren Marie Snoeyink, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1295 68th St Se, Grand Rapids, MI 49508 Phone: 616-970-3724 | |
Amanda Joy Rewa, MA, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 221 Trowbridge St Ne Apt 208, Grand Rapids, MI 49503 Phone: 231-755-8284 | |
Mrs. Marian Evelyn Lilly, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 40 Jefferson Ave Se, Grand Rapids, MI 49503 Phone: 616-356-6247 Fax: 616-732-6392 |