| Bluespace Counseling | |
|
149 N Center St Suite 200 Northville MI 48167-1486 | |
| (248) 880-8684 | |
| (734) 738-6980 |
| Full Name | Bluespace Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 149 N Center St, Northville, Michigan |
| Authorized Official Name and Position | Vicki L Bucciere (OWNER) |
| Authorized Official Contact | 2488808684 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluespace Counseling 44511 Broadmoor Blvd Northville MI 48168-8633 Ph: (248) 880-8684 | Bluespace Counseling 149 N Center St Suite 200 Northville MI 48167-1486 Ph: (248) 880-8684 |
| NPI Number | 1902204787 |
|---|---|
| Provider Enumeration Date | 12/10/2014 |
| Last Update Date | 12/10/2014 |
| Medicare PECOS PAC ID | 1850662743 |
|---|---|
| Medicare Enrollment ID | O20170811000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902204787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801018346 (Michigan) | Primary |
| Provider Name | Vicki Lynn Bucciere |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568876803 PECOS PAC ID: 0547531436 Enrollment ID: I20170821002691 |
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