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290 West 9 Mile Road Ferndale MI 48220 | |
| (248) 398-7105 | |
| (248) 541-1943 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 290 West 9 Mile Road, Ferndale, Michigan |
| Authorized Official Name and Position | Jeremy Merklinger (FINANCE DIRECTOR) |
| Authorized Official Contact | 3134128112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
290 West 9 Mile Road Ferndale MI 48220 Ph: (248) 398-7105 | 290 West 9 Mile Road Ferndale MI 48220 Ph: (248) 398-7105 |
| NPI Number | 1154681641 |
|---|---|
| Provider Enumeration Date | 05/18/2012 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Medicare PECOS PAC ID | 8426591546 |
|---|---|
| Medicare Enrollment ID | O20240618001293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154681641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Stacey Lyn Molinaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497220917 PECOS PAC ID: 0648513960 Enrollment ID: I20190529002428 |
| Provider Name | Catherine C Spinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326369158 PECOS PAC ID: 0547685356 Enrollment ID: I20200810002706 |
| Provider Name | Yawen Ning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710540620 PECOS PAC ID: 3779932645 Enrollment ID: I20231218002761 |
| Provider Name | Naheim Rida |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568111268 PECOS PAC ID: 1557807153 Enrollment ID: I20240718004469 |
| Provider Name | Ariel Gant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962860700 PECOS PAC ID: 3779020938 Enrollment ID: I20240806000549 |
| Provider Name | Brenden Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184395972 PECOS PAC ID: 2466993365 Enrollment ID: I20240918004639 |
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