| Forever Blooming Therapy Pllc | |
|
7912 S 8th St Kalamazoo MI 49009-8955 | |
| (269) 369-1869 | |
| Not Available |
| Full Name | Forever Blooming Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 7912 S 8th St, Kalamazoo, Michigan |
| Authorized Official Name and Position | Leah Rose Keller (MASTERS LEVEL CLINICAL THERAPIST) |
| Authorized Official Contact | 2693691869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forever Blooming Therapy Pllc 7912 S 8th St Kalamazoo MI 49009-8955 Ph: (269) 369-1869 | Forever Blooming Therapy Pllc 7912 S 8th St Kalamazoo MI 49009-8955 Ph: (269) 369-1869 |
| NPI Number | 1497520449 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 02/13/2024 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 6406290907 |
|---|---|
| Medicare Enrollment ID | O20240222002685 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497520449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leah R Keller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568849099 PECOS PAC ID: 3870814445 Enrollment ID: I20150608001946 |
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