| Clear Innervision Counseling Service, Llc | |
|
19304 Grand River Ave Detroit MI 48223-1202 | |
| (313) 467-3918 | |
| Not Available |
| Full Name | Clear Innervision Counseling Service, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19304 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Rhonda Jovette Miller (OWNER) |
| Authorized Official Contact | 3134677215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Innervision Counseling Service, Llc 16249 Eastwind St Romulus MI 48174-3180 Ph: (313) 467-3918 | Clear Innervision Counseling Service, Llc 19304 Grand River Ave Detroit MI 48223-1202 Ph: (313) 467-3918 |
| NPI Number | 1073025854 |
|---|---|
| Provider Enumeration Date | 11/01/2017 |
| Last Update Date | 01/22/2018 |
| Medicare PECOS PAC ID | 2668732520 |
|---|---|
| Medicare Enrollment ID | O20180214001435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073025854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801070834 (Michigan) | Primary |
| Provider Name | Rhonda J Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053556662 PECOS PAC ID: 1759448459 Enrollment ID: I20090325000171 |
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