Blue Water Mental Health Clinic | |
1501 Krafft Rd Fort Gratiot MI 48059-3565 | |
(810) 985-5125 | |
(810) 985-5127 |
Full Name | Blue Water Mental Health Clinic |
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Speciality | Clinic/Center |
Location | 1501 Krafft Rd, Fort Gratiot, Michigan |
Authorized Official Name and Position | Linda A Liethen (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8109855125 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Blue Water Mental Health Clinic 1501 Krafft Rd Fort Gratiot MI 48059-3565 Ph: (810) 985-5125 | Blue Water Mental Health Clinic 1501 Krafft Rd Fort Gratiot MI 48059-3565 Ph: (810) 985-5125 |
NPI Number | 1457305419 |
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Provider Enumeration Date | 05/22/2006 |
Last Update Date | 11/29/2016 |
Medicare PECOS PAC ID | 2769477264 |
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Medicare Enrollment ID | O20060531000214 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457305419 | NPI | - | NPPES |
Provider Name | Amy E Fabick |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1245263474 PECOS PAC ID: 2961455902 Enrollment ID: I20050302000115 |
Provider Name | Karen D Joseph |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1497834717 PECOS PAC ID: 1153346556 Enrollment ID: I20051013000711 |
Provider Name | Karl L Senkowski |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649361494 PECOS PAC ID: 1052389335 Enrollment ID: I20051212000624 |
Provider Name | Michele L Boyer |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1255448056 PECOS PAC ID: 2264436211 Enrollment ID: I20060912000294 |
Provider Name | Eva Waineo |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1265649180 PECOS PAC ID: 3375689169 Enrollment ID: I20091008000231 |
Provider Name | Sandra Oswell |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1588698401 PECOS PAC ID: 4688849532 Enrollment ID: I20111205000790 |
Provider Name | Heather Miller |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164790747 PECOS PAC ID: 4688841844 Enrollment ID: I20120111000862 |
Provider Name | Sara M Tavora |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003001819 PECOS PAC ID: 8123284411 Enrollment ID: I20120801000428 |
Provider Name | Shannon E Mckeever |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1629370101 PECOS PAC ID: 6103061007 Enrollment ID: I20130325000546 |
Provider Name | Kimberly R Peltz |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497986616 PECOS PAC ID: 0143456590 Enrollment ID: I20131113001803 |
Provider Name | Sara A Mchugh |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1962819011 PECOS PAC ID: 1557589769 Enrollment ID: I20140902000302 |
Provider Name | Hilary M Richards |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1679846059 PECOS PAC ID: 1850617861 Enrollment ID: I20150311000580 |
Provider Name | Stacy M Wynn |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1891083549 PECOS PAC ID: 3476863788 Enrollment ID: I20151116002643 |
Provider Name | Megan Bennett-o'brien |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1972513216 PECOS PAC ID: 3870858657 Enrollment ID: I20180525002108 |
Provider Name | April J Gardner |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023590536 PECOS PAC ID: 9032462478 Enrollment ID: I20181031003089 |
Provider Name | Brooke L Moore |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992156673 PECOS PAC ID: 5092040238 Enrollment ID: I20190711000057 |
Provider Name | Taylor M Crossley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679125363 PECOS PAC ID: 3971830365 Enrollment ID: I20190807003439 |
Provider Name | Maegan Wickstrom |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497363063 PECOS PAC ID: 2264893270 Enrollment ID: I20230807001191 |
Provider Name | Shelly M Papinaw |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1477854354 PECOS PAC ID: 4789029729 Enrollment ID: I20240229000308 |
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