| Conner Creek Life Solutions Llc | |
|
4777 E Outer Dr Detroit MI 48234-3241 | |
| (313) 369-5800 | |
| (313) 859-2000 |
| Full Name | Conner Creek Life Solutions Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4777 E Outer Dr, Detroit, Michigan |
| Authorized Official Name and Position | Andrew Mclemore (CEO) |
| Authorized Official Contact | 3133695098 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conner Creek Life Solutions Llc 4777 E Outer Dr Detroit MI 48234-3241 Ph: (313) 369-5800 | Conner Creek Life Solutions Llc 4777 E Outer Dr Detroit MI 48234-3241 Ph: (313) 369-5800 |
| NPI Number | 1659753085 |
|---|---|
| Provider Enumeration Date | 06/22/2015 |
| Last Update Date | 02/25/2022 |
| Certification Date | 02/25/2022 |
| Medicare PECOS PAC ID | 7113236472 |
|---|---|
| Medicare Enrollment ID | O20151027003045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659753085 | NPI | - | NPPES |
| 1659753085 | Medicaid | MI |
| Provider Name | Zakari M Tata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871591313 PECOS PAC ID: 9436049806 Enrollment ID: I20040318001713 |
| Provider Name | Kehinde A Ayeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366520470 PECOS PAC ID: 8729073580 Enrollment ID: I20040420000261 |
| Provider Name | Julia M Aharonov |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487619623 PECOS PAC ID: 0143272526 Enrollment ID: I20050214000672 |
| Provider Name | Joram O Mogaka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255407631 PECOS PAC ID: 8820044738 Enrollment ID: I20050328000123 |
| Provider Name | Karen L Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386642791 PECOS PAC ID: 1951303155 Enrollment ID: I20070131000569 |
| Provider Name | Xavier White |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265548903 PECOS PAC ID: 8123116985 Enrollment ID: I20071113000406 |
| Provider Name | Ribhi Hazin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265747463 PECOS PAC ID: 6901038140 Enrollment ID: I20140422001446 |
| Provider Name | Deniene D King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093107948 PECOS PAC ID: 1153631692 Enrollment ID: I20151112001155 |
| Provider Name | Lorine Kean-vaughn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417388976 PECOS PAC ID: 1355642687 Enrollment ID: I20151210001851 |
| Provider Name | Leniya Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740596758 PECOS PAC ID: 0446553903 Enrollment ID: I20160118000799 |
| Provider Name | Chinwe Prisca Ohaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700226875 PECOS PAC ID: 9436453685 Enrollment ID: I20160208001937 |
| Provider Name | Yolanda Y Cuff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215385851 PECOS PAC ID: 6406140615 Enrollment ID: I20160811000581 |
| Provider Name | Nalo Morant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154794311 PECOS PAC ID: 2769744234 Enrollment ID: I20180321000438 |
| Provider Name | Soraia Lynee Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942723176 PECOS PAC ID: 3375815244 Enrollment ID: I20180709000336 |
| Provider Name | Juilian M Bass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912476094 PECOS PAC ID: 2668713975 Enrollment ID: I20190416000192 |
| Provider Name | Kunal M Khatri |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508102724 PECOS PAC ID: 6204063506 Enrollment ID: I20200415002870 |
Bjc Counseling And Behavioral Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 16175 Asbury Park, Detroit, MI 48235 Phone: 313-673-1992 | |
Center For Establishing Recovery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Riverfront Dr Apt 2610, Detroit, MI 48226 Phone: 313-288-2689 | |
Community Social Services Of Wayne County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9851 Hamilton Ave, Detroit, MI 48202 Phone: 313-883-2339 Fax: 313-883-3957 | |
Emanuel T. Vanbolden, Phd, Lp, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 Farnsworth St, Detroit, MI 48202 Phone: 313-577-2840 Fax: 313-577-8949 | |
Mindful Synergy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3011 W Grand Blvd Ste 1507, Detroit, MI 48202 Phone: 313-608-9512 Fax: 313-462-4829 | |
Embody Her Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 Washington Blvd Ste 301, Detroit, MI 48226 Phone: 248-259-2562 | |
Ascension St John Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 586-753-0011 |