Family Supportive Services Of Northern Michigan Llc | |
121 N Mitchell St Cadillac MI 49601-1879 | |
(231) 878-8189 | |
(517) 323-9531 |
Full Name | Family Supportive Services Of Northern Michigan Llc |
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Speciality | Social Worker |
Location | 121 N Mitchell St, Cadillac, Michigan |
Authorized Official Name and Position | Jessica Deverman (OWNER) |
Authorized Official Contact | 2318788189 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Supportive Services Of Northern Michigan Llc 121 N Mitchell St Cadillac MI 49601-1879 Ph: (231) 878-8189 | Family Supportive Services Of Northern Michigan Llc 121 N Mitchell St Cadillac MI 49601-1879 Ph: (231) 878-8189 |
NPI Number | 1164943353 |
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Provider Enumeration Date | 06/28/2017 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 5092051144 |
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Medicare Enrollment ID | O20190109003415 |
Identifier | Type | State | Issuer |
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1164943353 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 6801095051 (Michigan) | Primary |
Provider Name | Chad M Campbell |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457461428 PECOS PAC ID: 8820022270 Enrollment ID: I20050924000086 |
Provider Name | Jessica Deverman |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659952836 PECOS PAC ID: 7315283322 Enrollment ID: I20220712000872 |
Provider Name | Katie Ranes |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1386355733 PECOS PAC ID: 8729422399 Enrollment ID: I20240222001372 |
Provider Name | Alicia Damgard |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1629731575 PECOS PAC ID: 5799123386 Enrollment ID: I20240402000968 |
Provider Name | Laura Porter |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1649758889 PECOS PAC ID: 1153863709 Enrollment ID: I20240611001041 |
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