| Five Lakes Counseling & Psychological Services | |
|
2675 44th St Sw Ste 301 Wyoming MI 49519-6833 | |
| (616) 557-6383 | |
| (616) 226-4739 |
| Full Name | Five Lakes Counseling & Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 2675 44th St Sw Ste 301, Wyoming, Michigan |
| Authorized Official Name and Position | Jennifer Bauer (FOUNDER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 6165576383 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Five Lakes Counseling & Psychological Services 2675 44th St Sw Ste 301 Wyoming MI 49519-6833 Ph: () - | Five Lakes Counseling & Psychological Services 2675 44th St Sw Ste 301 Wyoming MI 49519-6833 Ph: (616) 557-6383 |
| NPI Number | 1497506273 |
|---|---|
| Provider Enumeration Date | 03/29/2024 |
| Last Update Date | 07/15/2024 |
| Certification Date | 07/15/2024 |
| Medicare PECOS PAC ID | 0244672095 |
|---|---|
| Medicare Enrollment ID | O20240523003920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497506273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lisa W Bratsburg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093062523 PECOS PAC ID: 3971741430 Enrollment ID: I20130523000273 |
| Provider Name | Jennifer L Bauer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295044451 PECOS PAC ID: 1850705252 Enrollment ID: I20210126002627 |
| Provider Name | Joshua Colby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093943169 PECOS PAC ID: 4789033796 Enrollment ID: I20231214003644 |
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