| It's Your Journey Counseling Pllc | |
|
418 Broadway St South Haven MI 49090-1421 | |
| (269) 329-8708 | |
| Not Available |
| Full Name | It's Your Journey Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 418 Broadway St, South Haven, Michigan |
| Authorized Official Name and Position | Kellie Hakken (OWNER) |
| Authorized Official Contact | 2693298708 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| It's Your Journey Counseling Pllc 418 Broadway St South Haven MI 49090-1421 Ph: (269) 329-8708 | It's Your Journey Counseling Pllc 418 Broadway St South Haven MI 49090-1421 Ph: (269) 329-8708 |
| NPI Number | 1669072526 |
|---|---|
| Provider Enumeration Date | 10/29/2020 |
| Last Update Date | 10/31/2020 |
| Certification Date | 10/31/2020 |
| Medicare PECOS PAC ID | 7315358280 |
|---|---|
| Medicare Enrollment ID | O20201125000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669072526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Kellie Hakken |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740660968 PECOS PAC ID: 8729328828 Enrollment ID: I20190328000747 |
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