Cadillac Psychological Services, Pllc | |
121 N Mitchell St Cadillac MI 49601-1879 | |
(231) 884-0043 | |
Not Available |
Full Name | Cadillac Psychological Services, Pllc |
---|---|
Speciality | Psychologist |
Location | 121 N Mitchell St, Cadillac, Michigan |
Authorized Official Name and Position | Steven L Osborn (OWNER) |
Authorized Official Contact | 2318840043 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Cadillac Psychological Services, Pllc 121 N Mitchell St Cadillac MI 49601-1879 Ph: (231) 884-0043 | Cadillac Psychological Services, Pllc 121 N Mitchell St Cadillac MI 49601-1879 Ph: (231) 884-0043 |
NPI Number | 1932802972 |
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Provider Enumeration Date | 03/27/2023 |
Last Update Date | 01/18/2024 |
Certification Date | 01/18/2024 |
Medicare PECOS PAC ID | 4981049343 |
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Medicare Enrollment ID | O20240226002864 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932802972 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Steven L Osborn |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1588639546 PECOS PAC ID: 0648445858 Enrollment ID: I20111215000772 |
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