| Green Rose Counseling Pllc | |
|
409 Plymouth Rd Ste 270 Plymouth MI 48170-1842 | |
| (248) 758-8022 | |
| Not Available |
| Full Name | Green Rose Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 409 Plymouth Rd Ste 270, Plymouth, Michigan |
| Authorized Official Name and Position | Jennifer R Bogg (SOLE MEMBER) |
| Authorized Official Contact | 2487588022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Rose Counseling Pllc 409 Plymouth Rd Ste 270 Plymouth MI 48170-1842 Ph: (248) 758-8022 | Green Rose Counseling Pllc 409 Plymouth Rd Ste 270 Plymouth MI 48170-1842 Ph: (248) 758-8022 |
| NPI Number | 1639735061 |
|---|---|
| Provider Enumeration Date | 05/10/2019 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Medicare PECOS PAC ID | 6103152152 |
|---|---|
| Medicare Enrollment ID | O20190729002054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639735061 | NPI | - | NPPES |
| Provider Name | Andrea E Nowak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013921857 PECOS PAC ID: 9638230113 Enrollment ID: I20081202000583 |
| Provider Name | Kristi Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538404108 PECOS PAC ID: 4880848878 Enrollment ID: I20130128000382 |
| Provider Name | Jennifer R Bogg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932546413 PECOS PAC ID: 8527357748 Enrollment ID: I20160511001648 |
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