| Kalamazoo Act Psychotherapy Services | |
|
3505 Greenleaf Blvd Ste 201 Kalamazoo MI 49008-5616 | |
| (269) 366-4595 | |
| (269) 359-7222 |
| Full Name | Kalamazoo Act Psychotherapy Services |
|---|---|
| Speciality | Counselor |
| Location | 3505 Greenleaf Blvd Ste 201, Kalamazoo, Michigan |
| Authorized Official Name and Position | Julie Carbajal (OWNER) |
| Authorized Official Contact | 2693664595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kalamazoo Act Psychotherapy Services 3505 Greenleaf Blvd Ste 201 Kalamazoo MI 49008-5616 Ph: (269) 366-4595 | Kalamazoo Act Psychotherapy Services 3505 Greenleaf Blvd Ste 201 Kalamazoo MI 49008-5616 Ph: (269) 366-4595 |
| NPI Number | 1588260996 |
|---|---|
| Provider Enumeration Date | 12/10/2020 |
| Last Update Date | 07/09/2021 |
| Certification Date | 07/09/2021 |
| Medicare PECOS PAC ID | 9638565492 |
|---|---|
| Medicare Enrollment ID | O20220404000548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588260996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Millicent M Perkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700340817 PECOS PAC ID: 2668705088 Enrollment ID: I20190617002668 |
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