Elyse D'amico, Lmsw | |
427 S Stephenson Ave Ste 210 Iron Mountain MI 49801-3458 | |
(720) 840-7598 | |
Not Available |
Full Name | Elyse D'amico, Lmsw |
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Speciality | Social Worker |
Location | 427 S Stephenson Ave Ste 210, Iron Mountain, Michigan |
Authorized Official Name and Position | Elyse Damico (OWNER) |
Authorized Official Contact | 7208407598 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elyse D'amico, Lmsw Po Box 504 Iron Mountain MI 49801-0504 Ph: () - | Elyse D'amico, Lmsw 427 S Stephenson Ave Ste 210 Iron Mountain MI 49801-3458 Ph: (720) 840-7598 |
NPI Number | 1245749761 |
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Provider Enumeration Date | 09/27/2017 |
Last Update Date | 06/16/2018 |
Medicare PECOS PAC ID | 9739449109 |
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Medicare Enrollment ID | O20180202000689 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245749761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6801094872 (Michigan) | Primary |
Provider Name | Elyse Michelle D'amico |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528319852 PECOS PAC ID: 6305129503 Enrollment ID: I20170214001572 |
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