| Dearborn Counseling And Resource Center | |
|
2881 Monroe St Suite 201 Dearborn MI 48124-3475 | |
| (313) 359-1977 | |
| Not Available |
| Full Name | Dearborn Counseling And Resource Center |
|---|---|
| Speciality | Psychologist |
| Location | 2881 Monroe St, Dearborn, Michigan |
| Authorized Official Name and Position | Kathryn M Reilly (PRESIDENT) |
| Authorized Official Contact | 3133591977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dearborn Counseling And Resource Center 2881 Monroe St Suite 201 Dearborn MI 48124-3475 Ph: (313) 359-1977 | Dearborn Counseling And Resource Center 2881 Monroe St Suite 201 Dearborn MI 48124-3475 Ph: (313) 359-1977 |
| NPI Number | 1467664813 |
|---|---|
| Provider Enumeration Date | 05/05/2007 |
| Last Update Date | 04/14/2010 |
| Medicare PECOS PAC ID | 0042289274 |
|---|---|
| Medicare Enrollment ID | O20040924001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467664813 | NPI | - | NPPES |
| 1881718864 | Other | MI | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301008955 (Michigan) | Primary |
| 1041C0700X | Social Worker - Clinical | (Michigan) | Secondary |
| Provider Name | Kathryn M Reilly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881718864 PECOS PAC ID: 1850204645 Enrollment ID: I20031107000428 |
| Provider Name | Linda A Thibault |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952311201 PECOS PAC ID: 2163683459 Enrollment ID: I20120412000764 |
| Provider Name | Ellen L Fedon Keyt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851696488 PECOS PAC ID: 1355576893 Enrollment ID: I20131108000980 |
| Provider Name | Holly K Hale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144585308 PECOS PAC ID: 4082925441 Enrollment ID: I20150625002375 |
| Provider Name | Lawrence M Kalb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225331051 PECOS PAC ID: 4688827991 Enrollment ID: I20170120002308 |
| Provider Name | Hawra K Khraizat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801247747 PECOS PAC ID: 9133474802 Enrollment ID: I20180620002734 |
| Provider Name | Shirley Il Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821468851 PECOS PAC ID: 5294095477 Enrollment ID: I20190523000681 |
| Provider Name | Mira Cely |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992116222 PECOS PAC ID: 2062741325 Enrollment ID: I20190911002498 |
| Provider Name | Emily Cutler-brockway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366090334 PECOS PAC ID: 5193117059 Enrollment ID: I20220126002496 |
| Provider Name | Daniel James Horrigan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942723440 PECOS PAC ID: 4880067438 Enrollment ID: I20230301000440 |
| Provider Name | Ashley Kuroiwa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144889866 PECOS PAC ID: 8729453758 Enrollment ID: I20230405001301 |
| Provider Name | Cynthia Latka |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255997003 PECOS PAC ID: 5496103723 Enrollment ID: I20231128001442 |
| Provider Name | Fadowa Harrel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457715195 PECOS PAC ID: 7618325945 Enrollment ID: I20231128001617 |
| Provider Name | Christin Perry-michalik |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457584732 PECOS PAC ID: 7416305750 Enrollment ID: I20231128001720 |
| Provider Name | Corryn Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841802469 PECOS PAC ID: 2769831148 Enrollment ID: I20231211001788 |
| Provider Name | Adrienne Seeley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316491269 PECOS PAC ID: 4486996428 Enrollment ID: I20231215002304 |
| Provider Name | Annemarie Rini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740909811 PECOS PAC ID: 4082090881 Enrollment ID: I20240223001712 |
| Provider Name | Melissa Tavakoldavani |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427306828 PECOS PAC ID: 3779925987 Enrollment ID: I20240520002275 |
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