| Creekside Counseling Group Llc | |
|
10683 S Saginaw St Ste B Grand Blanc MI 48439-8127 | |
| (810) 771-4074 | |
| (810) 866-4450 |
| Full Name | Creekside Counseling Group Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10683 S Saginaw St Ste B, Grand Blanc, Michigan |
| Authorized Official Name and Position | Heather Renee Murphy (OWNER) |
| Authorized Official Contact | 8104223708 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Counseling Group Llc 10683 S Saginaw St Ste B Grand Blanc MI 48439-8127 Ph: (810) 771-4074 | Creekside Counseling Group Llc 10683 S Saginaw St Ste B Grand Blanc MI 48439-8127 Ph: (810) 771-4074 |
| NPI Number | 1619550860 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 9133521255 |
|---|---|
| Medicare Enrollment ID | O20210713000742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619550860 | NPI | - | NPPES |
| Provider Name | Heather Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972094936 PECOS PAC ID: 2567713910 Enrollment ID: I20180924002104 |
| Provider Name | Olivia K Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003278631 PECOS PAC ID: 7911246392 Enrollment ID: I20190301000169 |
| Provider Name | Kathleen C Enersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154797322 PECOS PAC ID: 6002236270 Enrollment ID: I20201009001547 |
| Provider Name | Quintin Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427423359 PECOS PAC ID: 0648678599 Enrollment ID: I20211007002562 |
| Provider Name | Tanya Roe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164852430 PECOS PAC ID: 6901279611 Enrollment ID: I20230228001844 |
| Provider Name | Tamara Pobocik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740816289 PECOS PAC ID: 2264880996 Enrollment ID: I20231118000567 |
| Provider Name | Erica M Woodward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194440263 PECOS PAC ID: 1153774765 Enrollment ID: I20240131000953 |
| Provider Name | Leah Katherine Stadel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598374852 PECOS PAC ID: 4688111982 Enrollment ID: I20240805001796 |
| Provider Name | Therese Ann Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972943686 PECOS PAC ID: 9739626045 Enrollment ID: I20240805002337 |
| Provider Name | Carla Anne Koon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770146284 PECOS PAC ID: 3072050228 Enrollment ID: I20240806000142 |
| Provider Name | Alisa Beth Rosario |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265022396 PECOS PAC ID: 5395282586 Enrollment ID: I20240806001634 |
| Provider Name | Shelley Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124899695 PECOS PAC ID: 0446790273 Enrollment ID: I20240909000506 |
| Provider Name | Monet Sutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437765336 PECOS PAC ID: 4284165648 Enrollment ID: I20241009002466 |
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