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5930 Lovers Ln Ste 3 Portage MI 49002-1673 | |
| (269) 381-6950 | |
| (269) 381-6954 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 5930 Lovers Ln Ste 3, Portage, Michigan |
| Authorized Official Name and Position | Ruqiya Tareen (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2693816950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5930 Lovers Ln Ste 3 Portage MI 49002-1673 Ph: (269) 381-6950 | 5930 Lovers Ln Ste 3 Portage MI 49002-1673 Ph: (269) 381-6950 |
| NPI Number | 1932635521 |
|---|---|
| Provider Enumeration Date | 05/03/2017 |
| Last Update Date | 05/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932635521 | NPI | - | NPPES |
| 1932194214 | Other | MI | NATIONAL IDENTIFICATION NUMBER |
| 1598724122 | Other | MI | NATIONAL IDENTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 4301078095 (Michigan) | Primary |
Michigan Integrated Therapies Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8080 Moorsbridge Rd Ste 102, Portage, MI 49024 Phone: 269-795-6681 | |
Millicent M Perkins Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5930 Lovers Ln, Portage, MI 49002 Phone: 269-344-9490 Fax: 269-344-8696 | |
Maternal Hope Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 640 Romence Rd Ste 211a, Portage, MI 49024 Phone: 269-359-7300 | |
Jomie Goerge, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1818 W Centre Ave, Portage, MI 49024 Phone: 269-377-4850 | |
Ascension Medical Group Promed Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8001 Angling Rd, Portage, MI 49024 Phone: 269-321-7090 | |
Southwest Michigan Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5250 Lovers Ln Ste 200, Portage, MI 49002 Phone: 800-676-0423 |