Core Counseling Center Llc | |
1345 Monroe Ave Nw Ste 234 Grand Rapids MI 49505-4692 | |
(616) 420-1060 | |
Not Available |
Full Name | Core Counseling Center Llc |
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Speciality | Counselor |
Location | 1345 Monroe Ave Nw Ste 234, Grand Rapids, Michigan |
Authorized Official Name and Position | Tierra Youngblood-field (PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 6164201060 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Core Counseling Center Llc 1345 Monroe Ave Nw Ste 234 Grand Rapids MI 49505-4692 Ph: () - | Core Counseling Center Llc 1345 Monroe Ave Nw Ste 234 Grand Rapids MI 49505-4692 Ph: (616) 420-1060 |
NPI Number | 1205320561 |
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Provider Enumeration Date | 06/20/2018 |
Last Update Date | 12/31/2019 |
Certification Date | 12/31/2019 |
Medicare PECOS PAC ID | 8820538002 |
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Medicare Enrollment ID | O20240914000233 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205320561 | NPI | - | NPPES |
1205320561 | Medicaid | MI |
Provider Name | Tierra Youngblood-field |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1346757762 PECOS PAC ID: 6709262207 Enrollment ID: I20240524000906 |
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