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113 Maple Blvd Cadillac MI 49601-9635 | |
| (231) 510-1645 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 113 Maple Blvd, Cadillac, Michigan |
| Authorized Official Name and Position | Lauren Hybza (OWNER/THERAPIST) |
| Authorized Official Contact | 2315101645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
113 Maple Blvd Cadillac MI 49601-9635 Ph: (231) 510-1645 | 113 Maple Blvd Cadillac MI 49601-9635 Ph: (231) 510-1645 |
| NPI Number | 1366121592 |
|---|---|
| Provider Enumeration Date | 07/14/2023 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 9931630365 |
|---|---|
| Medicare Enrollment ID | O20241009001360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366121592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lauren N Hybza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396123162 PECOS PAC ID: 0840721270 Enrollment ID: I20241009001440 |
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