| Insight Behavioral Wellness Of Northern Michigan Llc | |
|
537 S Garfield Ave Ste B Traverse City MI 49686-3484 | |
| (440) 915-8497 | |
| Not Available |
| Full Name | Insight Behavioral Wellness Of Northern Michigan Llc |
|---|---|
| Speciality | Psychologist |
| Location | 537 S Garfield Ave Ste B, Traverse City, Michigan |
| Authorized Official Name and Position | Barbara A Doremus (OWNER) |
| Authorized Official Contact | 4049750313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insight Behavioral Wellness Of Northern Michigan Llc 537 S Garfield Ave Ste B Traverse City MI 49686-3484 Ph: (440) 915-8497 | Insight Behavioral Wellness Of Northern Michigan Llc 537 S Garfield Ave Ste B Traverse City MI 49686-3484 Ph: (440) 915-8497 |
| NPI Number | 1942790894 |
|---|---|
| Provider Enumeration Date | 05/16/2018 |
| Last Update Date | 05/16/2018 |
| Medicare PECOS PAC ID | 5698022259 |
|---|---|
| Medicare Enrollment ID | O20180727002069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942790894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301017346 (Michigan) | Primary |
| Provider Name | Barbara A. Diedrick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487076964 PECOS PAC ID: 5395976245 Enrollment ID: I20180727002217 |
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