| Clarkston Family Therapists Llc | |
|
5639 Sashabaw Rd Clarkston MI 48346-3149 | |
| (248) 922-9077 | |
| (248) 922-9040 |
| Full Name | Clarkston Family Therapists Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5639 Sashabaw Rd, Clarkston, Michigan |
| Authorized Official Name and Position | Francis M Donnelly (OWNER) |
| Authorized Official Contact | 2489229077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarkston Family Therapists Llc 5639 Sashabaw Rd Clarkston MI 48346-3149 Ph: (248) 922-9077 | Clarkston Family Therapists Llc 5639 Sashabaw Rd Clarkston MI 48346-3149 Ph: (248) 922-9077 |
| NPI Number | 1326393752 |
|---|---|
| Provider Enumeration Date | 07/23/2012 |
| Last Update Date | 11/29/2012 |
| Medicare PECOS PAC ID | 8820240047 |
|---|---|
| Medicare Enrollment ID | O20121214000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326393752 | NPI | - | NPPES |
| 6301006011 | Other | MI | LICENSE |
| 6301009503 | Other | MI | LICENSE |
| 6801068002 | Other | MI | LICENSE |
| 103T00000X | Other | MI | TAXONOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (Michigan) | Primary |
| 1041C0700X | Social Worker - Clinical | (Michigan) | Secondary |
| Provider Name | Martha J Wright |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033290846 PECOS PAC ID: 4486656212 Enrollment ID: I20070208000035 |
| Provider Name | Joan A Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043376114 PECOS PAC ID: 6800954843 Enrollment ID: I20081021000352 |
| Provider Name | Sandra L Dougherty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831483874 PECOS PAC ID: 5092980094 Enrollment ID: I20111201000770 |
| Provider Name | Francis M Donnelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952480675 PECOS PAC ID: 9638321854 Enrollment ID: I20130111000245 |
| Provider Name | Lauren Victor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194105965 PECOS PAC ID: 8325355886 Enrollment ID: I20150915003389 |
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