| Judith K Moon Lmsw Acsw Llc | |
|
37399 Garfield Rd Ste 200 Clinton Twp MI 48036-3672 | |
| (586) 421-5164 | |
| (586) 421-5179 |
| Full Name | Judith K Moon Lmsw Acsw Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 37399 Garfield Rd Ste 200, Clinton Twp, Michigan |
| Authorized Official Name and Position | Judith Moon (OWNER) |
| Authorized Official Contact | 5864215164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Judith K Moon Lmsw Acsw Llc 37399 Garfield Rd Ste 200 Clinton Twp MI 48036-3672 Ph: (586) 421-5164 | Judith K Moon Lmsw Acsw Llc 37399 Garfield Rd Ste 200 Clinton Twp MI 48036-3672 Ph: (586) 421-5164 |
| NPI Number | 1114465184 |
|---|---|
| Provider Enumeration Date | 02/09/2017 |
| Last Update Date | 02/09/2017 |
| Medicare PECOS PAC ID | 3476837956 |
|---|---|
| Medicare Enrollment ID | O20170228002401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114465184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6801012981 (Michigan) | Primary |
| Provider Name | Judith K Moon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346355005 PECOS PAC ID: 1759307200 Enrollment ID: I20051024000517 |
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