| Gilbert Psychological Services, Llc | |
|
5060 Cascade Rd Se Ste D Grand Rapids MI 49546-3808 | |
| (616) 454-2911 | |
| (616) 454-1126 |
| Full Name | Gilbert Psychological Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5060 Cascade Rd Se Ste D, Grand Rapids, Michigan |
| Authorized Official Name and Position | Mary Gilbert (OWNER) |
| Authorized Official Contact | 6164542911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilbert Psychological Services, Llc 5060 Cascade Rd Se Ste D Grand Rapids MI 49546-3808 Ph: (616) 454-2911 | Gilbert Psychological Services, Llc 5060 Cascade Rd Se Ste D Grand Rapids MI 49546-3808 Ph: (616) 454-2911 |
| NPI Number | 1336678671 |
|---|---|
| Provider Enumeration Date | 06/09/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5991077422 |
|---|---|
| Medicare Enrollment ID | O20170818000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336678671 | NPI | - | NPPES |
| 6301010053 | Other | MI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mary S Gilbert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760426779 PECOS PAC ID: 0840376414 Enrollment ID: I20080324000113 |
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