| Addie Lanterman Therapy Services, Llc | |
|
2540 Harte Dr Ste A Brighton MI 48114-7014 | |
| (567) 703-0929 | |
| (734) 703-0929 |
| Full Name | Addie Lanterman Therapy Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2540 Harte Dr Ste A, Brighton, Michigan |
| Authorized Official Name and Position | Adrial Lanterman (OWNER) |
| Authorized Official Contact | 5677030929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Addie Lanterman Therapy Services, Llc 211 N 1st St Ste 286 Brighton MI 48116-1297 Ph: (567) 703-0929 | Addie Lanterman Therapy Services, Llc 2540 Harte Dr Ste A Brighton MI 48114-7014 Ph: (567) 703-0929 |
| NPI Number | 1730889742 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Medicare PECOS PAC ID | 0840644365 |
|---|---|
| Medicare Enrollment ID | O20231002001883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730889742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Adrial Mithril Lanterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548544612 PECOS PAC ID: 9739433384 Enrollment ID: I20181116001569 |
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