| A Radiant Mind Professional Counseling Services, Pllc | |
|
1850 Whites Rd Ste 5 Kalamazoo MI 49008-4801 | |
| (269) 808-0618 | |
| (269) 567-4113 |
| Full Name | A Radiant Mind Professional Counseling Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1850 Whites Rd Ste 5, Kalamazoo, Michigan |
| Authorized Official Name and Position | Samantha Middleton (CREDENTIALING) |
| Authorized Official Contact | 9893218918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Radiant Mind Professional Counseling Services, Pllc 1850 Whites Rd Ste 5 Kalamazoo MI 49008-4801 Ph: (269) 808-0618 | A Radiant Mind Professional Counseling Services, Pllc 1850 Whites Rd Ste 5 Kalamazoo MI 49008-4801 Ph: (269) 808-0618 |
| NPI Number | 1447983010 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 07/07/2023 |
| Certification Date | 07/07/2023 |
| Medicare PECOS PAC ID | 8729454723 |
|---|---|
| Medicare Enrollment ID | O20221017000973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447983010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jane Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770956278 PECOS PAC ID: 5193035491 Enrollment ID: I20151116002138 |
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