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1906 Fairmont St Lansing MI 48911-7121 | |
| (517) 899-0050 | |
| (877) 316-0026 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1906 Fairmont St, Lansing, Michigan |
| Authorized Official Name and Position | Kayla Lee Cox (OWNER) |
| Authorized Official Contact | 5178990050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1906 Fairmont St Lansing MI 48911-7121 Ph: (517) 899-0050 | 1906 Fairmont St Lansing MI 48911-7121 Ph: (517) 899-0050 |
| NPI Number | 1326764895 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Medicare PECOS PAC ID | 9335506351 |
|---|---|
| Medicare Enrollment ID | O20230607001166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326764895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kayla L Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225478225 PECOS PAC ID: 4486999521 Enrollment ID: I20181218003768 |
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