| Grounded In Grace Counseling Pllc | |
|
3054 Vixen Ct Wixom MI 48393-4564 | |
| (248) 506-6530 | |
| Not Available |
| Full Name | Grounded In Grace Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3054 Vixen Ct, Wixom, Michigan |
| Authorized Official Name and Position | Robyn Anne Jackson (CEO) |
| Authorized Official Contact | 2485066530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grounded In Grace Counseling Pllc 3054 Vixen Ct Wixom MI 48393-4564 Ph: (248) 506-6530 | Grounded In Grace Counseling Pllc 3054 Vixen Ct Wixom MI 48393-4564 Ph: (248) 506-6530 |
| NPI Number | 1346978517 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 08/15/2022 |
| Certification Date | 08/15/2022 |
| Medicare PECOS PAC ID | 2365986361 |
|---|---|
| Medicare Enrollment ID | O20240702000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346978517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robyn Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720750995 PECOS PAC ID: 2466841986 Enrollment ID: I20211122001854 |
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