| Rising Light Therapy | |
|
805 S State Rd # 182 Davison MI 48423-1751 | |
| (810) 379-0212 | |
| Not Available |
| Full Name | Rising Light Therapy |
|---|---|
| Speciality | Counselor |
| Location | 805 S State Rd # 182, Davison, Michigan |
| Authorized Official Name and Position | Brianna Dixon (PRACTITIONER) |
| Authorized Official Contact | 8103790212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Light Therapy 805 S State Rd # 182 Davison MI 48423-1751 Ph: (810) 379-0212 | Rising Light Therapy 805 S State Rd # 182 Davison MI 48423-1751 Ph: (810) 379-0212 |
| NPI Number | 1275203069 |
|---|---|
| Provider Enumeration Date | 09/14/2021 |
| Last Update Date | 06/22/2023 |
| Certification Date | 06/22/2023 |
| Medicare PECOS PAC ID | 2264895143 |
|---|---|
| Medicare Enrollment ID | O20231211003448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275203069 | NPI | - | NPPES |
| 1932574902 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brianna F Dixon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932574902 PECOS PAC ID: 4082077961 Enrollment ID: I20231211003464 |
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