| Crescent Roots Psychological Services, Pllc | |
|
115 N Center St Ste 202 Northville MI 48167-1469 | |
| (630) 313-2575 | |
| Not Available |
| Full Name | Crescent Roots Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 115 N Center St Ste 202, Northville, Michigan |
| Authorized Official Name and Position | Jason Beers (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6303132575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Roots Psychological Services, Pllc 115 N Center St Ste 202 Northville MI 48167-1469 Ph: (630) 313-2575 | Crescent Roots Psychological Services, Pllc 115 N Center St Ste 202 Northville MI 48167-1469 Ph: (630) 313-2575 |
| NPI Number | 1164988481 |
|---|---|
| Provider Enumeration Date | 02/11/2019 |
| Last Update Date | 02/13/2019 |
| Medicare PECOS PAC ID | 8628504263 |
|---|---|
| Medicare Enrollment ID | O20241206000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164988481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jason Beers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508235235 PECOS PAC ID: 2062770175 Enrollment ID: I20171219002326 |
| Provider Name | Wendy S Svatora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871749705 PECOS PAC ID: 0244599272 Enrollment ID: I20180119000852 |
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