| Georgianna Poulos Lmsw Llc | |
|
800 Monroe Ave Nw Ste 214 Grand Rapids MI 49503-1449 | |
| (734) 807-0207 | |
| Not Available |
| Full Name | Georgianna Poulos Lmsw Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 800 Monroe Ave Nw Ste 214, Grand Rapids, Michigan |
| Authorized Official Name and Position | Georgianna Poulos (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7348070207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgianna Poulos Lmsw Llc 800 Monroe Ave Nw Ste 214 Grand Rapids MI 49503-1449 Ph: (734) 807-0207 | Georgianna Poulos Lmsw Llc 800 Monroe Ave Nw Ste 214 Grand Rapids MI 49503-1449 Ph: (734) 807-0207 |
| NPI Number | 1538920558 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538920558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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