| Balanced Being Psychotherapy Pllc | |
|
904 Hawthorne Ave Ypsilanti MI 48198-5812 | |
| (734) 431-2166 | |
| Not Available |
| Full Name | Balanced Being Psychotherapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 904 Hawthorne Ave, Ypsilanti, Michigan |
| Authorized Official Name and Position | Mark D Pruitt (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7344312166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanced Being Psychotherapy Pllc 904 Hawthorne Ave Ypsilanti MI 48198-5812 Ph: (734) 431-2166 | Balanced Being Psychotherapy Pllc 904 Hawthorne Ave Ypsilanti MI 48198-5812 Ph: (734) 431-2166 |
| NPI Number | 1326804923 |
|---|---|
| Provider Enumeration Date | 02/22/2024 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Medicare PECOS PAC ID | 6800337445 |
|---|---|
| Medicare Enrollment ID | O20240923001470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326804923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mark D Pruitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538273743 PECOS PAC ID: 3779944558 Enrollment ID: I20230726000924 |
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