| Collaborative Counseling And Supervision, Pllc | |
|
3209 W Nelson St Midland MI 48640-3303 | |
| (616) 808-1965 | |
| Not Available |
| Full Name | Collaborative Counseling And Supervision, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3209 W Nelson St, Midland, Michigan |
| Authorized Official Name and Position | Kelly Fitzpatrick (OWNER) |
| Authorized Official Contact | 6168081965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Counseling And Supervision, Pllc 3209 W Nelson St Midland MI 48640-3303 Ph: (616) 808-1965 | Collaborative Counseling And Supervision, Pllc 3209 W Nelson St Midland MI 48640-3303 Ph: (616) 808-1965 |
| NPI Number | 1457056228 |
|---|---|
| Provider Enumeration Date | 04/03/2023 |
| Last Update Date | 04/03/2023 |
| Certification Date | 04/02/2023 |
| Medicare PECOS PAC ID | 1658738687 |
|---|---|
| Medicare Enrollment ID | O20230607001801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457056228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417517087 PECOS PAC ID: 6002219250 Enrollment ID: I20210726001424 |
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