| Grace Counseling Of Mid-michigan Llc | |
|
319 W Main St Ste A Ionia MI 48846-1610 | |
| (616) 523-4106 | |
| (616) 523-4139 |
| Full Name | Grace Counseling Of Mid-michigan Llc |
|---|---|
| Speciality | Counselor |
| Location | 319 W Main St Ste A, Ionia, Michigan |
| Authorized Official Name and Position | Diane L Jones (OWNER) |
| Authorized Official Contact | 9896212252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Counseling Of Mid-michigan Llc 319 W Main St Ste A Ionia MI 48846-1610 Ph: (616) 523-4106 | Grace Counseling Of Mid-michigan Llc 319 W Main St Ste A Ionia MI 48846-1610 Ph: (616) 523-4106 |
| NPI Number | 1194250001 |
|---|---|
| Provider Enumeration Date | 04/28/2017 |
| Last Update Date | 11/10/2021 |
| Certification Date | 11/10/2021 |
| Medicare PECOS PAC ID | 6406264571 |
|---|---|
| Medicare Enrollment ID | O20210410000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194250001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6401012695 (Michigan) | Primary |
| Provider Name | Jamie L Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730550641 PECOS PAC ID: 2466700166 Enrollment ID: I20180810002518 |
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