| Coat Of Many Colors Llc | |
|
3333 S Pennsylvania Ave Ste 100 Lansing MI 48910-4795 | |
| (517) 798-4944 | |
| Not Available |
| Full Name | Coat Of Many Colors Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3333 S Pennsylvania Ave Ste 100, Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coat Of Many Colors Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Coat Of Many Colors Llc 3333 S Pennsylvania Ave Ste 100 Lansing MI 48910-4795 Ph: (517) 798-4944 |
| NPI Number | 1205245461 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 5991046765 |
|---|---|
| Medicare Enrollment ID | O20190403002132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205245461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Cheri G Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326076340 PECOS PAC ID: 7416910666 Enrollment ID: I20041109000078 |
| Provider Name | Dominique Prince |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407209935 PECOS PAC ID: 1951644541 Enrollment ID: I20190522002869 |
| Provider Name | Eneziah Walters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194383802 PECOS PAC ID: 0749690840 Enrollment ID: I20201030001250 |
| Provider Name | Tameka S Billingslea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538755988 PECOS PAC ID: 1951714856 Enrollment ID: I20210114001350 |
| Provider Name | Nyree A Scroggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811147317 PECOS PAC ID: 0547673303 Enrollment ID: I20210115001444 |
| Provider Name | Toccara E Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568813871 PECOS PAC ID: 5496162372 Enrollment ID: I20210319000890 |
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