| Annette L Fortino Lcsw Acsw Cac-ii Llc | |
|
101 S James St Ste 306 Ludington MI 49431-2166 | |
| (517) 231-6550 | |
| Not Available |
| Full Name | Annette L Fortino Lcsw Acsw Cac-ii Llc |
|---|---|
| Speciality | Social Worker |
| Location | 101 S James St Ste 306, Ludington, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Annette L Fortino Lcsw Acsw Cac-ii Llc Po Box 10 Mason MI 48854-0010 Ph: (517) 676-9788 | Annette L Fortino Lcsw Acsw Cac-ii Llc 101 S James St Ste 306 Ludington MI 49431-2166 Ph: (517) 231-6550 |
| NPI Number | 1871879080 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Medicare PECOS PAC ID | 4981862281 |
|---|---|
| Medicare Enrollment ID | O20120215000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871879080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Annette L Fortino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194838599 PECOS PAC ID: 9436147865 Enrollment ID: I20040504001442 |
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