| Lauren Berthelot, Lmsw | |
|
880 Munson Ave Ste G Traverse City MI 49686-3661 | |
| (231) 944-0384 | |
| Not Available |
| Full Name | Lauren Berthelot, Lmsw |
|---|---|
| Speciality | Social Worker |
| Location | 880 Munson Ave Ste G, Traverse City, Michigan |
| Authorized Official Name and Position | Patricia Lauren Berthelot (OWNER) |
| Authorized Official Contact | 2319440384 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren Berthelot, Lmsw Po Box 2257 Chesterton IN 46304-0357 Ph: (219) 926-8320 | Lauren Berthelot, Lmsw 880 Munson Ave Ste G Traverse City MI 49686-3661 Ph: (231) 944-0384 |
| NPI Number | 1326606369 |
|---|---|
| Provider Enumeration Date | 06/04/2019 |
| Last Update Date | 10/27/2022 |
| Certification Date | 10/27/2022 |
| Medicare PECOS PAC ID | 4587098215 |
|---|---|
| Medicare Enrollment ID | O20200106000317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326606369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia Lauren Berthelot |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689044406 PECOS PAC ID: 5496189128 Enrollment ID: I20200106000429 |
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