| Anxiety Disorders Cbt Llc | |
|
214 S Bridge St Ste C Grand Ledge MI 48837-1587 | |
| (810) 772-4351 | |
| Not Available |
| Full Name | Anxiety Disorders Cbt Llc |
|---|---|
| Speciality | Psychologist |
| Location | 214 S Bridge St Ste C, Grand Ledge, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anxiety Disorders Cbt Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Anxiety Disorders Cbt Llc 214 S Bridge St Ste C Grand Ledge MI 48837-1587 Ph: (810) 772-4351 |
| NPI Number | 1518460799 |
|---|---|
| Provider Enumeration Date | 03/14/2018 |
| Last Update Date | 08/06/2019 |
| Medicare PECOS PAC ID | 8224391719 |
|---|---|
| Medicare Enrollment ID | O20180416001470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518460799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301011111 (Michigan) | Primary |
| Provider Name | Kenneth L Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659464238 PECOS PAC ID: 3476682667 Enrollment ID: I20100526000757 |
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