| Blue Mind Wellness, Llc | |
|
18565 Woodduck Dr Spring Lake MI 49456-2901 | |
| (269) 744-2604 | |
| Not Available |
| Full Name | Blue Mind Wellness, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 18565 Woodduck Dr, Spring Lake, Michigan |
| Authorized Official Name and Position | Elizabeth Ann Pellegrom (THERAPIST/OWNER) |
| Authorized Official Contact | 2697442604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Mind Wellness, Llc 18565 Woodduck Dr Spring Lake MI 49456-2901 Ph: (269) 744-2604 | Blue Mind Wellness, Llc 18565 Woodduck Dr Spring Lake MI 49456-2901 Ph: (269) 744-2604 |
| NPI Number | 1467138115 |
|---|---|
| Provider Enumeration Date | 06/27/2023 |
| Last Update Date | 06/27/2023 |
| Certification Date | 06/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467138115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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