| Health Psychology Pc | |
|
3335 S. 9th Street Kalamazoo MI 49009 | |
| (269) 375-0624 | |
| (269) 375-0008 |
| Full Name | Health Psychology Pc |
|---|---|
| Speciality | Psychologist |
| Location | 3335 S. 9th Street, Kalamazoo, Michigan |
| Authorized Official Name and Position | Patricia R. Williams (VICE PRESIDENT) |
| Authorized Official Contact | 2693750624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Psychology Pc P.o. Box 263 Oshtemo MI 49077-0263 Ph: (269) 375-0624 | Health Psychology Pc 3335 S. 9th Street Kalamazoo MI 49009 Ph: (269) 375-0624 |
| NPI Number | 1134273766 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/04/2011 |
| Medicare PECOS PAC ID | 2466621420 |
|---|---|
| Medicare Enrollment ID | O20110808000676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134273766 | NPI | - | NPPES |
| 8008902000 | Other | MI | BLUE CROSS |
| 680C945110 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301001976 (Michigan) | Primary |
| 104100000X | Social Worker | 6801065401 (Michigan) | Secondary |
| Provider Name | Patricia R Tracy Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194879882 PECOS PAC ID: 4183893159 Enrollment ID: I20140430001850 |
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