| Jacqui Hicks Connective Healings Pllc | |
|
351 Coventry Ln Mason MI 48854-1162 | |
| (517) 604-8083 | |
| Not Available |
| Full Name | Jacqui Hicks Connective Healings Pllc |
|---|---|
| Speciality | Counselor |
| Location | 351 Coventry Ln, Mason, Michigan |
| Authorized Official Name and Position | Marybeth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqui Hicks Connective Healings Pllc Po Box 10 Mason MI 48854-0010 Ph: () - | Jacqui Hicks Connective Healings Pllc 351 Coventry Ln Mason MI 48854-1162 Ph: (517) 604-8083 |
| NPI Number | 1891391066 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 6507209921 |
|---|---|
| Medicare Enrollment ID | O20240213000915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891391066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Jacquelyn Suzanne Hicks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447860689 PECOS PAC ID: 8224471644 Enrollment ID: I20240213001038 |
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