| Axon Psychology Group, Pc | |
|
2500 Niles Rd Ste 5 Saint Joseph MI 49085-3225 | |
| (269) 281-0408 | |
| (269) 281-4065 |
| Full Name | Axon Psychology Group, Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2500 Niles Rd Ste 5, Saint Joseph, Michigan |
| Authorized Official Name and Position | Christopher Contardo (PRESIDENT) |
| Authorized Official Contact | 6174359641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Axon Psychology Group, Pc 2500 Niles Rd Ste 5 Saint Joseph MI 49085-3225 Ph: (269) 281-0408 | Axon Psychology Group, Pc 2500 Niles Rd Ste 5 Saint Joseph MI 49085-3225 Ph: (269) 281-0408 |
| NPI Number | 1265046098 |
|---|---|
| Provider Enumeration Date | 08/31/2020 |
| Last Update Date | 12/07/2020 |
| Certification Date | 12/07/2020 |
| Medicare PECOS PAC ID | 6507286721 |
|---|---|
| Medicare Enrollment ID | O20201008003029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265046098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Christopher Trigger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609032093 PECOS PAC ID: 6103952726 Enrollment ID: I20101115001026 |
| Provider Name | Lorena Marjorie Newkirk |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689907800 PECOS PAC ID: 9739361031 Enrollment ID: I20110308000569 |
| Provider Name | Stephanie M Slye |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649356379 PECOS PAC ID: 2365623949 Enrollment ID: I20130107000219 |
| Provider Name | Christopher P Contardo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245559798 PECOS PAC ID: 9739213489 Enrollment ID: I20130425000272 |
| Provider Name | Laura L Flynn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790056570 PECOS PAC ID: 6901065119 Enrollment ID: I20220314000658 |
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