| Jann La Dere Msw Llc | |
|
616 Petoskey St Ste 3 Petoskey MI 49770-2779 | |
| (231) 203-3231 | |
| (231) 758-1041 |
| Full Name | Jann La Dere Msw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 616 Petoskey St Ste 3, Petoskey, Michigan |
| Authorized Official Name and Position | Janet Marie Ladere (OWNER/THERAPIST) |
| Authorized Official Contact | 2312033231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jann La Dere Msw Llc 616 Petoskey St Ste 3 Petoskey MI 49770-2779 Ph: (231) 203-3231 | Jann La Dere Msw Llc 616 Petoskey St Ste 3 Petoskey MI 49770-2779 Ph: (231) 203-3231 |
| NPI Number | 1649851379 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 5294174629 |
|---|---|
| Medicare Enrollment ID | O20240418002372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649851379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Janet Marie Ladere |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689026379 PECOS PAC ID: 6305271172 Enrollment ID: I20200124001328 |
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