| Conscious Healing Therapy Pllc | |
|
569 Wildwood Ave Unit 4 Jackson MI 49201-1048 | |
| (734) 219-9636 | |
| Not Available |
| Full Name | Conscious Healing Therapy Pllc |
|---|---|
| Speciality | Counselor |
| Location | 569 Wildwood Ave Unit 4, Jackson, 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 |
|---|---|
| Conscious Healing Therapy Pllc Po Box 10 Mason MI 48854-0010 Ph: () - | Conscious Healing Therapy Pllc 569 Wildwood Ave Unit 4 Jackson MI 49201-1048 Ph: (734) 219-9636 |
| NPI Number | 1124626577 |
|---|---|
| Provider Enumeration Date | 10/16/2020 |
| Last Update Date | 12/20/2023 |
| Certification Date | 12/20/2023 |
| Medicare PECOS PAC ID | 4587014089 |
|---|---|
| Medicare Enrollment ID | O20231226000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124626577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Cassondra K Mcginn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992008619 PECOS PAC ID: 5496105991 Enrollment ID: I20231226000677 |
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