| Blu Iris Therapeutic Services,llc | |
|
189 W Clarkston Rd Ste 208 Lake Orion MI 48362-2892 | |
| (248) 284-3331 | |
| Not Available |
| Full Name | Blu Iris Therapeutic Services,llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 189 W Clarkston Rd Ste 208, Lake Orion, Michigan |
| Authorized Official Name and Position | Lisa P Farrell-byrski (OWNER/THERAPIST) |
| Authorized Official Contact | 2622275776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blu Iris Therapeutic Services,llc 189 W Clarkston Rd Ste 208 Lake Orion MI 48362-2892 Ph: (248) 284-3331 | Blu Iris Therapeutic Services,llc 189 W Clarkston Rd Ste 208 Lake Orion MI 48362-2892 Ph: (248) 284-3331 |
| NPI Number | 1144939406 |
|---|---|
| Provider Enumeration Date | 11/15/2022 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Medicare PECOS PAC ID | 1456722990 |
|---|---|
| Medicare Enrollment ID | O20230120001723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144939406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lisa P Farrell-byrski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881151017 PECOS PAC ID: 0446676696 Enrollment ID: I20200818002750 |
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