| Bright Pine, Inc. | |
|
6913 Fox Ln Waterford MI 48327-3506 | |
| (248) 404-8816 | |
| Not Available |
| Full Name | Bright Pine, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 6913 Fox Ln, Waterford, Michigan |
| Authorized Official Name and Position | Katherine Ann Lewitzke (LICENSED PSYCHOLOGIST, DIRECTOR) |
| Authorized Official Contact | 2484048816 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Pine, Inc. 6913 Fox Ln Waterford MI 48327-3506 Ph: (248) 404-8816 | Bright Pine, Inc. 6913 Fox Ln Waterford MI 48327-3506 Ph: (248) 404-8816 |
| NPI Number | 1063927085 |
|---|---|
| Provider Enumeration Date | 12/13/2017 |
| Last Update Date | 12/13/2017 |
| Medicare PECOS PAC ID | 0547525396 |
|---|---|
| Medicare Enrollment ID | O20180525000795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063927085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Katherine Lewitzke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891031381 PECOS PAC ID: 0648525253 Enrollment ID: I20180622002286 |
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