| Agentic Behavioral Health Llc | |
|
21653 Phoenix Dr Macomb MI 48044-6408 | |
| (248) 659-2422 | |
| (586) 333-5780 |
| Full Name | Agentic Behavioral Health Llc |
|---|---|
| Speciality | Social Worker |
| Location | 21653 Phoenix Dr, Macomb, Michigan |
| Authorized Official Name and Position | Angela Arnold (OWNER) |
| Authorized Official Contact | 2486592422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agentic Behavioral Health Llc 21653 Phoenix Dr Macomb MI 48044-6408 Ph: (248) 659-2422 | Agentic Behavioral Health Llc 21653 Phoenix Dr Macomb MI 48044-6408 Ph: (248) 659-2422 |
| NPI Number | 1710513015 |
|---|---|
| Provider Enumeration Date | 03/18/2020 |
| Last Update Date | 03/18/2020 |
| Certification Date | 03/18/2020 |
| Medicare PECOS PAC ID | 6901236967 |
|---|---|
| Medicare Enrollment ID | O20200415003371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710513015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Arnold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568879542 PECOS PAC ID: 8325347941 Enrollment ID: I20160504000369 |
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