| Kerrie Clark Counseling, Llc | |
|
5005 Plainfield Ave Ne Ste 100 Grand Rapids MI 49525-2087 | |
| (616) 279-3869 | |
| (616) 608-4657 |
| Full Name | Kerrie Clark Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5005 Plainfield Ave Ne Ste 100, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kerrie Clark (OWNER) |
| Authorized Official Contact | 6162793869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kerrie Clark Counseling, Llc 5005 Plainfield Ave Ne Ste 100 Grand Rapids MI 49525-2087 Ph: (616) 279-3869 | Kerrie Clark Counseling, Llc 5005 Plainfield Ave Ne Ste 100 Grand Rapids MI 49525-2087 Ph: (616) 279-3869 |
| NPI Number | 1982475661 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 9931544749 |
|---|---|
| Medicare Enrollment ID | O20240304000890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982475661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kerrie Ann Clark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225360662 PECOS PAC ID: 2365887171 Enrollment ID: I20240304001180 |
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