Agius Psychological Services, Llc | |
1440 Torrey Rd Ste E Fenton MI 48430 | |
(810) 288-6652 | |
Not Available |
Full Name | Agius Psychological Services, Llc |
---|---|
Speciality | Psychologist |
Location | 1440 Torrey Rd Ste E, Fenton, Michigan |
Authorized Official Name and Position | Johnathan Agius (OWNER) |
Authorized Official Contact | 8102886652 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Agius Psychological Services, Llc 237 Armstrong St Fenton MI 48430-1728 Ph: (810) 210-4894 | Agius Psychological Services, Llc 1440 Torrey Rd Ste E Fenton MI 48430 Ph: (810) 288-6652 |
NPI Number | 1306376546 |
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Provider Enumeration Date | 06/19/2017 |
Last Update Date | 06/04/2018 |
Medicare PECOS PAC ID | 3375814577 |
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Medicare Enrollment ID | O20170807001839 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306376546 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Johnathan Agius |
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Provider Type | Practitioner - Psychologist Billing Independently |
Provider Identifiers | NPI Number: 1659762441 PECOS PAC ID: 4284905480 Enrollment ID: I20180607002655 |
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