| Helle Augustesen, Pc | |
|
5380 Holiday Ter Kalamazoo MI 49009-2154 | |
| (269) 343-3464 | |
| Not Available |
| Full Name | Helle Augustesen, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 5380 Holiday Ter, Kalamazoo, Michigan |
| Authorized Official Name and Position | Helle Augustesen (PRESIDENT) |
| Authorized Official Contact | 2693433464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Helle Augustesen, Pc 15795 Port Sheldon St West Olive MI 49460-8802 Ph: () - | Helle Augustesen, Pc 5380 Holiday Ter Kalamazoo MI 49009-2154 Ph: (269) 343-3464 |
| NPI Number | 1770860090 |
|---|---|
| Provider Enumeration Date | 11/15/2011 |
| Last Update Date | 11/15/2011 |
| Medicare PECOS PAC ID | 9234397811 |
|---|---|
| Medicare Enrollment ID | O20120229000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770860090 | NPI | - | NPPES |
| 11286346 | Other | CAQH PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301008602 (Michigan) | Primary |
| Provider Name | Helle A Augustesen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043226699 PECOS PAC ID: 0941294102 Enrollment ID: I20040412000450 |
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