| Etch | |
|
909 Abbot Rd Ste B East Lansing MI 48823-3168 | |
| (269) 430-3122 | |
| Not Available |
| Full Name | Etch |
|---|---|
| Speciality | Social Worker |
| Location | 909 Abbot Rd Ste B, East Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etch Po Box 10 Mason MI 48854-0010 Ph: (517) 676-9788 | Etch 909 Abbot Rd Ste B East Lansing MI 48823-3168 Ph: (269) 430-3122 |
| NPI Number | 1689075806 |
|---|---|
| Provider Enumeration Date | 09/08/2014 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 7517289481 |
|---|---|
| Medicare Enrollment ID | O20141203001633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689075806 | NPI | - | NPPES |
| Provider Name | Catherine C Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982667598 PECOS PAC ID: 0446312714 Enrollment ID: I20081219000439 |
| Provider Name | Rochelle N Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467926592 PECOS PAC ID: 1557601853 Enrollment ID: I20190325000789 |
| Provider Name | Michelle Colpean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750739835 PECOS PAC ID: 7315327350 Enrollment ID: I20220707002726 |
| Provider Name | Elizabeth Ana Peralta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134799133 PECOS PAC ID: 6305205253 Enrollment ID: I20230710003359 |
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